Immunohistochemical analysis of cell cycle-regulating-protein (p21, p27, and Ki-67) expression in gastroesophageal reflux disease
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- 作者：Yorihiro Nishiyama ; Shigeki Koyama ; Akira Andoh ; Suzuko Moritani ; Ryoji Kushima ; Yoshihide Fujiyama ; Takanori Hattori and Tadao Bamba
- 关键词：Key words ; endoscopy ; lamina propria ; inflammation
- 刊名：Journal of Gastroenterology
- 出版年：2002
- 出版时间：November 2002
- 年：2002
- 卷：37
- 期：11
- 页码：905-911
- 全文大小：507 KB
文摘
The aim of this study was to carry out an immunohistochemical analysis of cell cycle-regulating-protein (p21, p27, and Ki-67) expression in endoscopic biopsy samples obtained using angled biopsy forceps. Methods: The study was based on the examination of endoscopic esophageal biopsy specimens obtained from 46 patients with evidence of reflux and from 10 normal control subjects without clinical reflux. Results:The percentage of samples containing the lamina propria was 5.7 % using standard forceps (n = 53) and 83.3 % using the angled forceps (n = 67). The use of angled forceps allowed the detection of inflammatory cell accumulation in the lamina propria even in patients with modified Los Angeles (LA) system grades N and M. In normal esophageal mucosa, Ki-67-positive cells were detected within the lower parts of the basal zone, and p21- and p27-positive cells were not detected. In samples from grade N and M patients, no histological changes were detectable by standard H&E staining. However, the area of Ki-67-positive cells was slightly expanded compared with normal mucosa, and p21- and p27-positive cells were clearly detectable from the lower to middle part of the epithelium. The area of Ki-67-, p21-, and p27-positive cells tended to expand upward in the epithelium with gastroesophageal reflux disease (GERD) severity based on the LA classification grading. Conclusions: The use of angled biopsy forceps allows the evaluation of inflammatory responses at the level of the lamina propria and makes it possible to assess the expression of cell cycle-regulating proteins in the entire epithelium. The evaluation of these responses may be helpful in the diagnosis of endoscopically negative GERD.