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目的：通过对食管和贲门癌原发病灶和淋巴结转移病灶ｐ５３变化规律的研究，加深对食管和贲门癌转移发生的分子病理学基础的了解。方法：采用免疫组织化学（ＡＢＣ）方法，对３１例食管和贲门癌原发病灶和转移病灶ｐ５３蛋白聚集进行了研究。结果：３１例手术标本中，２４例为食管磷状细胞癌，７例为贲门腺癌。研究表明：在２４例食管原发和转移鳞癌中，有１１例原发和转移癌灶中均出现ｐ５３蛋白聚集的变化，原发和转移癌灶的一致性变化发生率为６１％（１１／１８），Ｐ＜０．０５；在６例原发病灶ｐ５３免疫组化阴性患者中，其淋巴结转移病灶也同时出现免疫阴性反应。在７例胃贲门腺癌中，３例原发和转移癌灶同时出现ｐ５３免疫阳性表达的一致率为５０％（３／６），Ｐ＞０．０５；１例原发病灶ｐ５３免疫组化阴性患者，其淋巴结转移病灶也出现阴性反应。结论：ｐ５３在食管和贲门癌癌变和转移中起一定的作用。
OBJECTIVE: To deepen the understanding of the molecular pathology of esophageal and cardiac cancer metastasis by studying the changes of p53 in the primary lesions of esophageal and cardiac cancers and lymph node metastases. Methods: Immunohistochemistry (ABC) method was used to study the p53 protein aggregation in primary and metastatic lesions of 31 esophageal and cardiac cancers. RESULTS: Of the 31 surgical specimens, 24 were esophageal squamous cell carcinomas and 7 were cardial adenocarcinomas. Studies have shown that in 24 cases of primary and metastatic squamous cell carcinoma of the esophagus, p53 protein aggregation was observed in 11 cases of primary and metastatic cancers, and the coincident change rate of primary and metastatic foci was 61% (11%). /18), P<0.05; In 6 patients with primary lesions with p53 immunohistochemistry negative, lymph node metastases also showed negative immunoreactivity. In 7 cases of gastric cardia adenocarcinoma, the consistent rate of p53 immunopositive expression in 3 cases of primary and metastatic foci simultaneously was 50% (3/6), P>0.05; 1 case of p53 immunohistochemistry in primary lesions Negative patients also have negative reactions in lymph node metastases. Conclusion: p53 plays a role in the carcinogenesis and metastasis of esophageal and cardiac cancers.