barrett食管粘膜的微细结构及意义 - 第三军医大学学报.doc

Barrett食管上皮的微细结构及意义 赵晶京 房殿春 肖桃园 彭贵勇 章容 徐承平 于冬梅 作者单位：4000038 重庆市第三军医大学西南医院全军消化病专科中心（赵晶京、房殿春、彭贵勇），病理科（章容、徐承平、于冬梅），重庆市第三军医大学电镜室（肖桃园） 作者: 赵晶京, Tel: Email：zhaojingjing1973＠ 摘要 目的 通过透射电镜技术观察ultrastructure and significance in Barrett’s esophageal epithelium Zhao Jing-jing, Fang Dian-chun, Peng Gui-yong. Department of Gastroenterology；Xiao Tao-yuan. Department of electron microscopy; Zhang Rong，Xu Cheng-ping，Yu Dong-mei. Department of Pathology, the Southwest Hospital, the Third Millitary Medical University,Chongqing 400038,China [Abstract] Objective To observe ultrastructure in Barrett’s esophageal epithelium.using transmission electron microscopy and approach the significance. Methods Barrett’s esophagus were screened by endoscopy. Biopsy specimens in the distal oesophagus were fixed in 10% buffered formalin for the histopathological diagnosis. Some biopsy specimens from the patients with Barrett’s esophagus whose histology showed a specialised intestinal epithelium were fixed in 2.5% glutaraldehyde for subsequent transmission electron microscopy study. Results Under transmission electron microscopy, an intermediate cell type between mucous cell and goblet cell was found in the surface of Barretts specialized intestinal metaplasia, and a special cell type of both squamous and columnar cell fetures was found under the surface of Barretts specialized intestinal metaplasia. Conclusion The special cell type of both squamous and columnar cell fetures seen by transmission electron microscopy study may be the result of transformation of multipotential stem cells of squamous epithelial origin and the intermediate cell may represent an intermediate stage in the development of Barretts specialized intestinal metaplasia. [Key words] Barrett’s oesophagus; ultrastructure Barrett食管是指食管下段鳞状上皮被柱状上皮取代的一种病理现象，研究证实是长期胃食管反流的结果，属于食管腺癌的的癌前病变，尤其是Barrett食管肠化上皮具有癌变的高风险[1]。本研究筛选Barrett食管病例，采用透射电镜技术观察1? 资料与方法1.1? 一般资料?106例。对所有疑诊Barrett食管病例在食管下段行内镜下粘膜活检，并立即分别置于福尔马林、戊二醛中固定， 1.2