胃黏膜球样异型增生Ki-67、P53、bcl-2及bax的表达

目的　采用免疫组化方法检测了 41例胃黏膜球样异型增生Ki -67、P5 3、bcl -2及bax的表达 ,以探讨其增殖活性程度和与癌的关系。方法　复查胜利石油管理局中心医院 1993年～ 1994年收检的外科手术切除胃癌标本 ,从中检出伴有球样异型增生者 41例 ,包括球样异型增生I级 2 3例 ,II级 11例 ,III级 7例。免疫组化标记Ki -67、P5 3、bcl-2及bax。结果　 41例胃黏膜球样异型增生分别见于高分化腺癌、低分化腺癌、黏液腺癌、印戒细胞癌。 2例见与印戒细胞癌有形态移行 ,3例见与低分化管状腺癌移行。多数球样异型增生细胞显示Ki-67、P5 3、bcl -2及bax阳性。与正常胃黏膜比较 ,球样异型增生细胞Ki -67、P5 3表达增高 ,高级别者与癌接近。球样异型增生细胞bcl-2表达较低 ,bax表达较高 ,但较高级别的球样异型增生细胞bcl -2表达增高 ,bcl-2 /bax比值增高。结论　胃黏膜球样异型增生细胞增生活跃 ,可能与多种类型胃癌的发生有关。

Expression of Ki-67,p53,bcl-2 and Bax in Gastric Globoid Dysplasia

Objective To examine the expression of Ki-67,p53,bcl-2 and bax in gastric globoid dysplasia and the relationship between globoid dysplasia and gastric carcinoma.Methods An immunohistochemical staining was used to detect the expression of Ki-67,p53,bcl-2 and bax in 41 cases of gastric globoid dysplasia ,92 gastric carcinoma and 92 normal gastric mucosa.Results 41 cases gastic globoid dyplasia were seen in well differentiated adenocarcinoma,poor differentiated adnocarcinoma,mucinous adenocarcinoma and signet ring cell carcinoma.The histologic transition of globoid dysplasia to carcinoma was in 2 cases signet ring cell carcinoma and 3 poor differentiated tubular adenocarcinoma.Most cells of globoid dysplasia were positive of Ki-67,p53,bcl-2 and bax.The expression of Ki-67 and p53 in globoid dysplasia was higher than that in normal gastric mucosa and approached carcinoma level.The expression of bcl-2 was lower but of bax was higher in globoid dysplasia than that in normal.However,the expression of bcl-2 in higher grade globoid dysplasia was heightened.Conclusions Gastric globoid dysplasia is special active .It is possible that gastric globoid dysplasia is correlated to the occurrence of varied gastric carcinoma.