利用分子生物标志物表达检测早期食道发育不良改变

▶Bird-Lieberman厄尔， Neves AA, Lao-Sirieix P，等．使用荧光凝集素的分子成像可以通过内窥镜快速识别Barrett食管的异型增生。Nat地中海2012;18: 315 - 22所示。

食道腺癌的发病率在增加，传统上预后较差。Barrett食管是一种恶性前表型，目前，检测疾病进展的监测策略包括重复标准内窥镜和活检。这种方法是持续争论和辩论的焦点。问题是小的发育不良病灶很难在宏观上发现，经常被二次切片检查遗漏。本文报道了一种新的、荧光标记的特异性分子检测策略，以识别与Barrett食管相关的发育不良食管上皮。糖在上皮细胞表面表达，人类样本的初步遗传分析显示，发育不良的食道细胞有异常的表达模式。然后通过凝集素探针与该分子靶标的特异性结合来检测糖聚糖的表达模式。基因阵列和免疫组化验证数据显示凝集素结合模式与细胞发育不良程度相关。特异性凝集素WGA的结合与巴雷特氏上皮从低级别异型增生到高级别异型增生的进展呈负相关，且不受与反流相关的炎症程度的影响。然后在四个新鲜的人食管切除标本上进行体内测试，每个标本都包含不同水平的组织发育不良变化。 A fluorescein-labelled lectin was sprayed topically onto the mucosal surface and then imaged using a fluorescent endoscope. There was a highly significant correlation between histology and fluorescent lectin staining to detect dysplasia, including areas not macroscopically visible with standard white light endoscopy. This strategy may allow specific areas to be targeted for biopsy and subsequent endoscopic treatment. The authors discuss that some additional exploration of this is required, such as toxicity, and determination …