Expression and its correlations of caudal type homeobox transcription factor-2, heparin-binding epidermal growth factor-like growth factor and bone morphogenetic protein-4 in Barrett's esophagus / 中华消化杂志

ABSTRACT

Objective To explore the function and significance of caudal type homeobox transcription factor-2 (CDX)-2,heparin-binding epidermal growth factor-like growth factor (HB-EGF) and bone morphogenetic protein 4 (BMP-4) of esophageal stromal tissues in the pathogenesis of Barrett's esophagus (BE).Methods A total of 116 patients were divided into groups according to gastroscopic finds and hematoxylin-eosin (H &E) staining of biopsy samples.They were divided into control group (n=29),RE group (n=32),BE group (n=35),RE treatment group (n=10) and BE treatment group (n=10).The expression of CDX 2,HB-EGF and BMP-4 in different esophageal mucosal lesions was detected by immunohistochemical staining and the changes of positive expression levels of CDX-2,HBEGF and BMP 4 were compared among groups.Variance analysis and chi-square analysis were performed to analyze the correlation among the three factors.Results The CDX-2 positive cell number of control group ((0.0±0.0)/high power field(HPF)),RE group ((43.1±10.6)/HPF),and BE group ((67.8±11.3)/HPF) increased in turn,and the differences among three groups were statistically significant (F=67.664,P＜0.01).The HBEGF positive ((6.4±1.4)/HPF,(39.4±13.5)/HPF,(55.8±13.9)/HPF) and BMP 4 positive ((0.0±0.0)/HPF,(22.6±6.4)/HPF and ((25.1± 10.3)/HPF) cell number of three groups had the same trend and the differences among three groups were statistically significant (F HB-EGF =22.925,FBMP-4 =10.463,both P＜0.01).Except the expression of BMP-4 between RE group and BE group,there were significant differences between every other two groups (LSD test,all P＜ 0.01).The expression of CDX 2,HB EGF,BMP-4 in RE treatment group ((21.7±1.7)/HPF,(16.6±5.0)/HPF and (9.2±1.0)/HPF) and BE treatment group ((51.4±8.7)/HPF,(31.0± 10.4)/HPF and (12.7±3.9)/HPF) were lower than those in RE group and BE group respectively,the differences were also statistically significant (LSD test,all P＜0.05).In RE group,the positive rate of CDX-2 (31.2％ (10/32)) was significantly lower than that of HBEGF and BMP4 (62.5％ (20/32) and 56.2％(18/32)),and the differences were statistically significant (x2=6.275 and 4.063,both P＜0.05).However in BE group,there was no statistically significant difference in the positive rate among CDX-2(85.7％(30/35)),HB-EGF (88.6％(31/35)) and BMP-4 (74.3％(26/35),all P＞0.05).Conclusions CDX-2,HB-EGF and BMP-4 may play an important role in the pathogenesis of RE and BE.HB-EGF and BMP-4 may be involved in the early episodes of BE genesis and have promotion effects on CDX-2 expression.HB-EGF and BMP-4 may be the new target in the research and treatment of BE.