The thesis is dedicated to study morphological, immunohistochemical, molecular and genetic features of maturation, differentiation and specialization of the epithelium differon of the gastroesophageal junction (the GEJ), establishments of patterns of cellular differons development of the GEJ epithelium during prenatal period of human ontogenesis. In work the following methods of research were applied: the general histological, morphometric, immunohistochemical methods of investigation of necropsy material of the human embryos and fetuses, biopsic and surgical material from patients with cancer of the GEJ and also laboratory and instrumental examination of these patients, statistical processing of the received data.
The current study carried out on the material received under international standards of bioethics from 169 human embryos and fetuses with gestational age 4-38 weeks. Along with the embryos and fetuses we studied histochemical features of glycoproteins distribution in the cytoplasm of neoplastic cells of 90 patients ill with cancer of GEJ. During evaluation of the patients condition, which have cancer of the GEJ, the international classification TNM was used.
Done for the first time comparative histochemical estimation of the glycoproteins distribution in the GEJ epithelium differon of embryos and fetuses and neoplastic cells of cancer of the GEJ of adults established, that histochemical properties of adenocarcinoma G1 (gastric type), corresponded to the last three weeks of pregnancy (late fetal period), intestinal G1 type – transition of embryonal into embryofetal period (8th week), adenocarcinoma G2 (gastric and intestinal types) - of embryonal into embryofetal (8th week) period and fetal period (18-20 weeks), whereas adenocarcinomas G3 corresponded to the early fetal period (10-28 weeks), when transdifferentiation of the columnar epithelium in to the stratified sguamous is happening. Mixed type of secretion of adenocarcinomas (G1-G3) corresponded to 18th week of gestation, for which appearance of alcianophilic gastric epithelium of the GEJ is typical. Our goal was to find out predictive aspects of transcription factors and cytokeratins participation in formation of different types of the GEJ epithelium. Basic differon lines of the GEJ epithelium were established during prenatal period of ontogenesis: 4-6 gestational weeks – pluripotential stem cells with positive expression of p63, Sox2, CK14, CK8/18, CK7; 17-38 weeks - progenitor cells of the stratified squamous epithelium of esophageal part of the GEJ with positive expression of Sox2, p632, CK14; 14-38 weeks - progenitor cells of the simple columnar epithelium of cardiac parts of the GEJ with positive expression of Sox2, CK8/18, CK7. Key words: gastroesophageal junction, morphology, epithelial differon, prenatal ontogenesis, immunohistochemistry. Branch-Medicine.
