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目的：通过西安市和林州市食管癌ｐ５３ 基因高表达率、危险因素及其第五外显子突变谱和突变模式的比较研究，初步探讨两地食管癌分子病因的异同。方法：分别在西安市和林州市收集食管癌病例１３７ 例、６７ 例及相应对照，调查其相关既往史；对癌组织以免疫组化和 Ｐ Ｃ Ｒ 直接测序方法检测 Ｐ５３ 蛋白和ｐ５３ 基因第五外显子突变情况；危险因素分析以单因素分析和多因素 Ｌｏｇｉｓｔｉｃ 回归模型进行。结果：西安市食管癌发病及 Ｐ５３ 高表达与吸烟和食管癌家族史有关，而林州市则与食用酸菜和食管癌家族史有关。西安市病例ｐ５３ 第五外显子突变谱相对集中（１５７ 、１５９ 密码子为主） ， Ｇ→ Ｔ 颠换较多见（５／１０） ；而林州市病例突变位点较分散。结论：ｐ５３ 突变和食管癌家族史是两地食管癌的共同病因，但两地ｐ５３ 基因突变的环境因素、突变谱和模式差异较大，表明其分子癌变机理也可能不同。
OBJECTIVE: To compare the high expression rate of p53 gene, risk factors and the mutation spectrum and mutation pattern of exon 5 in esophageal cancer in Xi’an and Linzhou City, and to explore the similarities and differences of molecular etiology of esophageal cancer in the two regions. Methods: 137 cases and 67 cases of esophageal cancer cases were collected from Xi’an and Linzhou respectively to investigate the related past history. P53 protein and p53 gene were detected by immunohistochemistry and P C R direct sequencing method. Five exon mutations; risk factor analysis was performed using single factor analysis and multivariate logistic regression models. Results: The incidence of esophageal cancer and the high expression of P53 in Xi’an were related to smoking and the family history of esophageal cancer, while Linzhou was related to the family history of food sauerkraut and esophageal cancer. The mutation spectrum of exon 5 of p53 in cases of Xi’an was relatively concentrated (mainly 157 and 159 codons), G→T transversion was more common (5/10), and the mutation sites in Linzhou City were more scattered. Conclusion: The p53 mutation and family history of esophageal cancer are the common causes of esophageal cancer in the two places. However, the p53 gene mutations in the two places have different environmental factors, mutation patterns, and patterns, suggesting that their molecular cancer mechanisms may also be different.