不同病变胃粘膜端粒酶活性及其亚单位的检测

目的：探讨端粒酶及其亚单位（ＴＰ１、ｈＴＲ、ｈＴＲＴ）在胃粘膜癌变过程中的作用。方法：端粒酶的检测采用端粒末端重复序列扩增技术（ｔｅｌｏｍｅｒｉｃ　ｒｅｐｅａｔ　ａｍｐｌｉｆｉｃａｔｉｏｎ　ｐｒｏｔｏｃｏｌ,ＴＲＡＰ）,端粒酶亚单位的检测采用ＲＴ－ＰＣＲ法。结果：端粒酶阳性检出率在慢性萎缩性胃炎、肠上皮化生、异型增生及胃癌中分别为２４．６％（１４／５７）、３８．９％（７／１８）、３７．５％（３／８）及９２．３％（６０／６５）,正常胃粘膜未检测到端粒酶活性,与以上各病变组织有显著性差异（Ｐ＜０．０５～０．０１）,而慢性萎缩性胃炎、肠上皮化生和异型增生组织中端粒酶阳性率亦明显低于胃癌组织（Ｐ＜０．０１）;端粒酶的表达与临床病理指标无相关性;ＲＴ－ＰＣＲ定性检测发现端粒酶亚单位ｈＴＲ和ＴＰ１在大多数胃粘膜中都有表达,而ｈＴＲＴ主要在胃癌及部分癌前组织中表达,且在胃癌中ｈＴＲＴ的表达与端粒酶活性之间具有明显的相关性（Ｐ＜０．０１）。结论：端粒酶不仅在胃癌组织中高表达,在部分癌前组织中也有表达。提示端粒酶在胃癌的发生过程中可能具有重要作用;端粒酶亚单位ｈＴＲＴ不仅可能作为胃癌的诊断指标,而且还可能作为胃癌基因治疗的靶     

Overexpression of human telomerase RNA in Helicobacter pylori-infected human gastric mucosa.

Telomerase, an enzyme associated with cellular immortality and malignancy, plays an important role in cellular immortalization and tumorigenesis. Furthermore, overexpression of the RNA component of the telomerase, called human telomerase RNA (hTR), has been demonstrated in various human cancers as an early event. The pattern of hTR expression following Helicobacter pylori (H. pylori) infection in human gastric mucosa was investigated by a radioactive in situ hybridization (ISH) assay. Paraffin-embedded sections of 50 biopsy specimens taken from the gastric antrum of individual patients infected to different extents with H. pylori, as well as normal gastric mucosa, were studied. In normal gastric mucosa, only weak hTR expression was noted and the expression was limited to basal cells of the gastric glands. However, the degree of hTR expression gradually increased in parallel with the degree of H. pylori infection. The mean scores of gastric mucosa with mild, moderate and severe degrees of H. pylori infection were 2.3, 2.8, and 3.7 times higher than that of normal gastric mucosa, respectively. The results of this study suggested that up-regulation of hTR expression is a frequent and early event associated with H. pylori infection in the gastric mucosa and may play some role in gastric carcinogenesis. Sufficient synthesis of hTR during this early stage may be a prerequisite for telomerase reactivation to occur in gastric cancer.     

Overexpression of Human Telomerase RNA in Helicobacter pylori-infected Human Gastric Mucosa

Telomerase, an enzyme associated with cellular immortality and malignancy, plays an important role in cellular immortalization and tumorigenesis. Furthermore, overexpression of the RNA component of the telomerase, called human telomerase RNA (hTR), has been demonstrated in various human cancers as an early event. The pattern of hTR expression following Helicobacter pylori ( H. pylori ) infection in human gastric mucosa was investigated by a radioactive in situ hybridization (ISH) assay. Paraffin-embedded sections of 50 biopsy specimens taken from the gastric antrum of individual patients infected to different extents with H. pylori , as well as normal gastric mucosa, were studied. In normal gastric mucosa, only weak hTR expression was noted and the expression was limited to basal cells of the gastric glands. However, the degree of hTR expression gradually increased in parallel with the degree of H. pylori infection. The mean scores of gastric mucosa with mild, moderate and severe degrees of H. pylori infection were 2.3, 2.8, and 3.7 times higher than that of normal gastric mucosa, respectively. The results of this study suggested that up-regulation of hTR expression is a frequent and early event associated with H. pylori infection in the gastric mucosa and may play some role in gastric carcinogenesis. Sufficient synthesis of hTR during this early stage may be a prerequisite for telomerase reactivation to occur in gastric cancer.     

In situ mRNA Hybridization Technique for Analysis of Human Telomerase RNA in Gastric Precancerous and Cancerous Lesions

Telomerase, the ribonucleoprotein enzyme that elongates telomeres, is repressed in normal somatic cells but is reactivated during tumor progression. The purpose of this study was to investigate the localization of human telomerase RNA (hTR) expression in human gastric precancerous and cancerous lesions by using in situ mRNA hybridization (ISH) with avidin-biotin staining. We also examined telomerase activity in these lesions by using hybridization protection assay connected with a telomeric repeat amplification protocol (TRAP/HPA). Analyzed tissue samples were as follows; 132 cases of chronic atrophic gastritis without intestinal metaplasia, 115 incomplete-type intestinal metaplasias, 40 complete-type intestinal metaplasias, 23 hyperplastic polyps, 23 tubular adenomas and 26 adenocarcinomas. In ISH analysis, high levels of hTR expression were observed preferentially in the nuclei at the single-cell level. hTR-expressing cells in carcinomas and adenomas were significantly more frequent than those of the other lesions ( P <0.001). The expression pattern of hTR in carcinoma and adenoma tissues was heterogeneous and similar intratumor heterogeneity was detected in Ki-67 immunoreactivity. Infiltrating lymphocytes in tissues also exhibited high levels of hTR expression. In TRAP/HPA analysis, carcinomas had significantly more frequent positivity for telomerase activity and a higher level of telomerase activity than the other lesions ( P <0.05). However, the amount of telomerase activity did not parallel the expression level of hTR. Our data suggest that hTR expression increases in the early stages of stomach carcinogenesis and that sufficient synthesis of hTR is a prerequisite for telomerase reactivation in tumorigenesis.     

幽门螺旋杆菌感染胃黏膜COX-2和P-gp表达与胃癌发生

背景与目的通过检测幽门螺旋杆菌(Helicobacter Pylori,H.pylori)感染胃粘膜组织环氧合酶-2(Cyclooxygenase-2,COX-2)和多药耐药-1(Multidrug resistance-1,MDR-1)基因表达产物P糖蛋白(P-glycoprotein,P-gp)表达,探讨幽门螺旋杆菌相关胃癌的发生机制,以及P-gp高表达的机制。材料与方法慢性胃炎155例(30例慢性浅表性、40例慢性萎缩性、45例肠化、40例非典型增生)及胃癌80例(肠型40例,弥漫型40例),COX-2和P-gp表达检测选择免疫组化S-P法,H.pylori感染检测采用快速脲素酶及改良Giemsa染色方法。结果H.pylori阳性感染率、COX-2和P-gp的阳性表达率,肠型胃癌均明显高于弥漫型胃癌(P<0.01)。慢性萎缩性胃炎、肠化、非典型增生及肠型胃癌中H.pylori感染与COX-2的表达呈正相关(P<0.01)。H.pylori感染的慢性浅表性胃炎、慢性萎缩性胃炎、肠化、非典型增生及肠型胃癌中COX-2的表达与P-gp的表达也均呈正相关(P<0.01)。结论H.pylori依赖的COX-2表达与P-gp表达有关,可能有助于胃癌形成以及胃癌对化疗抵制。     

慢性胃病伴肠上皮化生、胃癌与幽门螺旋杆菌感染的关系

目的探讨慢性胃病伴肠上皮化生、胃癌与幽门螺旋杆菌（helicobacter pylore,HP）感染的关系。方法采用warthin—strarry银染色方法,对380例慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡组织及胃癌的癌旁组织进行HP检测．应用（alcianblue—PH2．5-periodic—schiff,AB—PAS）、（high-iron—diamine-alcianblue—PH2．5,HID-AB）黏液组织化学方法,区别慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡组织及胃癌的癌旁组织伴有肠上皮化生的类型。结果总例数380例。HP阳性率为69．74％。慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡组织及胃癌的癌旁组织伴肠上皮化生的HP感染率分别为77．78％、85．71％、100．00％、80．95％。慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡及胃癌的癌旁组织伴肠上皮化生AB—PAS染色阳性率分别为86．84％、91．43％、93．33％、100．00％;HID—AB染色阳性率分别为34．21％、42．86％、53．33％、85．71％。癌旁组织的肠上皮化生中,78．57％为不完全大肠型,慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡伴肠上皮化生中,不完全小肠型比例分别为52．63％、54．28％、53．33％;不完全大肠型比例分别为28．95％、31．43％、20．00％。结论HP感染与慢性胃病伴肠上皮化生及胃癌的发生密切相关。癌旁组织的不完全大肠型肠上皮化生与胃癌的发生密切相关;慢性胃病组织当中的小灶状不完全大肠型上皮化生具有潜在发生癌变的可能性。     

幽门螺杆菌感染和环氧合酶-2表达在胃癌发生中的作用

目的探讨幽门螺杆菌 (Hp) 感染和环氧合酶-2(COX-2)表达在胃癌发生中的作用.方法 138例胃镜活检标本包括慢性非萎缩性胃炎30例,慢性萎缩性胃炎85例(其中伴有中度以上肠化生45例,中、重度异型增生12例),和胃癌23例.快速尿素酶试验和组织学改良Giemsa染色联合检测Hp,免疫组化检查COX-1和COX-2表达.结果胃癌的Hp阳性率为69.6%,显著高于慢性非萎缩性胃炎的36.7%(P<0.05).慢性非萎缩性胃炎、慢性萎缩性胃炎、肠化生、异型增生和胃癌的COX-2表达率分别为10.0%、37.6%、37.8%、41.7%和69.6%,而不同胃黏膜病变中COX-1表达无明显差异.慢性萎缩性胃炎、肠化生和异型增生中Hp阳性病例的COX-2表达显著高于Hp阴性病例(P<0.01).结论 Hp感染及其诱导的COX-2表达可能是胃癌发生的早期事件之一.     

Helicobactor pylori infection is closely associated with telomere reduction in gastric mucosa

OBJECTIVE: To investigate differential reduction in telomere DNA in tissue components of gastric mucosa with respect to Helicobactor pylori infection. MATERIALS AND METHODS: The telomere content was examined by fluorescent in situ hybridization with the (TTAGGG)(4) probe. To compare the signal intensities from the probe (telomere volume) with telomere length, five gastric carcinoma cell lines were used. Telomere volumes were examined in 9 healthy persons, 124 non-cancer patients, and 86 gastric cancer patients. RESULTS: Telomere volume showed a linear correlation with telomere length measured by Southern blotting in gastric carcinoma cells. In healthy persons without H. pylori infection, the telomere volumes of gastric epithelial tissues were 70-79% that of intramucosal lymphocytes (internal control). In 124 patients without gastric cancer, telomere volume of H.-PYLORI-infected mucosa was significantly less than that of H.-pylori-negative mucosa in both metaplastic and non- metaplastic tissues (p < 0.0001). In 86 gastric cancer patients, telomere volumes in intestinal metaplasia adjacent to cancer were 75% that of intestinal metaplasia of non-cancer patients (p = 0.0001). hTERT expression was detected in 6 cancer-associated and 2 cancer-negative intestinal metaplasia specimens, in which telomere volume was markedly reduced. CONCLUSION: H. pylori infection is closely associated with telomere reduction in gastric epithelium.     

胃癌及癌前病变与幽门螺杆菌感染相关性的临床分析

目的:测定幽门螺杆菌在萎缩肠化生胃炎,异型增生及胃癌中感染情况,探讨Hp与它们的相关性。方法:萎缩肠化生胃炎(A组)患者342例,异型增生(B组)229例,胃癌患者(C组)298例,采用Hp抗体ELISA法检测血清抗Hp-IgG抗体。结果:肠化生患者较非肠化生胃黏膜中的Hp感染多见。异型增生和胃癌的Hp感染率均高于萎缩性胃炎组(P<0.05),异型增生和胃癌两者间的Hp感染率亦存在差异(P<0.05)。幽门螺杆菌感染的萎缩肠化生胃炎及异性增生较非幽门螺杆菌感染者发生癌变的差异性显著,P<0.05;幽门螺杆菌感染的胃癌5年生存期显著短于非感染者,P<0.05。结论:Hp感染与萎缩肠化生胃炎,异型增生及胃癌有密切相关性,并缩短萎缩肠化生胃炎,异型增生癌变时间,缩短胃癌5年生存时间。     

Telomere length and telomerase activity in carcinogenesis of the stomach

Telomerase activity is generally absent in primary cell cultures and normal tissues. Telomerase is known to be induced upon immortalization or malignant transformation of human cells. In the present study, we analyzed both telomere length and telomerase activity in biopsy samples from mucosa undergoing metaplasia, adenoma and cancer of the stomach. We attempted to estimate the correlation between telomerase activity and telomere length in these tissues. Telomerase activity was estimated using the telomeric repeat amplification protocol and telomere length by Southern blot analysis. Extracts were defined as telomerase-negative when the signals were less intense than those for 10(2) KATO-III cells (positive control). We detected telomerase activity in 15%, 45% and 89% of the examined cases of intestinal metaplasia, adenoma and gastric cancer respectively. However, telomere length in the gastric mucosa became reduced as the mucosa underwent metaplasia and developed into adenoma. Gastric cancers showed a broad range of telomere length among cases. However, gastric adenomas showed the shortest telomere length. These results suggest that telomerase is expressed during the early phase (intestinal metaplasia through adenoma) of gastric carcinogenesis, although the activity at that stage is not high enough to fully restore the reduced telomeric DNA.      

胃癌及癌前病变与幽门螺杆菌

目的　幽门螺杆菌 (Helicobacterpylori,Hpylori)感染与胃癌的关系一直倍受人们关注 ,检查胃癌及癌前病变 ,如萎缩性胃炎、肠腺化生、异型增生病人Hpylori感染情况 ,了解Hpylori感染与胃癌的关系。方法　通过胃镜钳取胃粘膜 ,用快速尿素酶试验法(RUT)、PCR法、HE银染法等三种方法同时检查 ,判定Hpylori感染 ,并作病理细胞学检查。共查萎缩性胃炎 89例、肠腺化生 64例、异型增生 47例、胃癌 3 0例 ,功能性消化不良 10 3例作为对照。结果　Hpylori阳性率在萎缩性胃炎、肠腺化生病人中较高 ,分别是79 3 %和 81 3 % ,与对照组功能性消化不良病人 (阳性率 61 2 % )相比有显著统计学差异 ,P值均小于 0 0 1。异型增生组Hp阳性率较低 72 % ,与对照组相比P >0 0 5 ,无显著统计学差异。胃癌病人与对照组相比P <0 0 5 ,Hp阳性率显著降低。结论　Hpylori感染与萎缩性胃炎、胃粘膜肠腺化生密切相关 ,与异型增生、胃癌无直接关系。Hpylori感染主要参与癌前病变的前期阶段 ,是胃癌的高危险因素     

Helicobacter pylori Infection Promotes Gastric Premalignancies and Malignancies Lesions and Demotes Hyperplastic Polyps: A 5 Year Multicentric Study among Cameroonian Dyspeptic Patients

Background: Helicobacter pylori infection is the most well-known risk factor for gastric mucosa abnormalities. However, some geographic regions with persistent high H. pylori infection rates do not suffer from high gastric mucosa lesions incidence. The aim of the study was to establish the relationship between H. pylori infection and gastric pathological features in Cameroon. Methods: We performed a retrospective study, collecting data from the University Teaching Hospital and the Cameroon Pasteur institute on 1290 patients (mean age 46.31 ± 16.45 years, sex ratio 1.19:1) for whom histological features of the gastric mucosa and H. pylori infection were investigated from 2014 to 2019. Data were extracted from the medical records; hospital computerized databases; or clinical charts of these patients and reviewed according to gender and age of participants. The study was approved by the Ethical Committee of Medical Sciences. Result: Approximately 3% (2.56%) of the sample population were with normal gastric mucosa whereas chronic gastritis, atrophic gastritis, intestinal metaplasia, dysplasia, carcinoma, hyperplastic polyps and MALT lymphoma was found in 75.35, 8.2, 7.7, 2.8, 9.3, 1.55 and 0.8% of cases respectively. Unlike hyperplasia (OR= 0.3838), infected participants were in a high risk to develop gastric lesions with an odds ratio of 1.1775, 1.4866, 1.4415, 1.2088, 0.9408 and 0.9075 for gastritis, atrophic gastric, dysplasia, carcinoma, intestinal metaplasia and MALT lymphoma respectively. Conclusion: our finding showed that chronic gastritis, gastric premalignancies and malignancies are positively link to Helicobacter pylori infection and that hyperplastic polyp is inversely associated with H. pylori infection in our milieu.     

Caveolin-1在胃癌组织中的表达及临床生物学意义

背景与目的:Caveolin-1作为候选抑癌基因,在多种肿瘤均有异常表达。本研究探讨Caveolin-1在非癌胃粘膜、肠上皮化生、异型增生和胃癌组织以及胃癌细胞系MGC803和BGC823的表达特点。方法:采用冰冻组织微阵列的免疫组织化学(immunohistochemistry,IHC)染色,在完全相同的实验条件下检测56例胃癌及29例非癌粘膜、11例肠上皮化生、7例异型增生组织中Caveolin-1的表达状况,及其与胃癌的临床病理分期、淋巴结转移、Lauren分型及组织学分型的关系。Westernblot和RT-PCR法检测胃癌及相应癌旁组织与MGC-803和BGC-823细胞中Caveolin-1蛋白和RNA的表达情况。结果:免疫组化结果显示,Caveolin-1在非癌胃粘膜、肠上皮化生、异型增生和胃癌中的阳性率分别为86.2%(25/29)、81.8%(9/11)、57.1%(4/7)、17.9%(10/56);胃癌与其它各组间的阳性率有显著性差异(P<0.05)。进展期胃癌的Caveolin-1阳性率(16.0%)低于早期胃癌(33.3%),但无统计学意义(P>0.05)。弥漫型胃癌的阳性率(7.0%)明显低于肠型胃癌(26.9%,P<0.05)。有淋巴结转移的胃癌Caveolin-1阳性率(9.7%)低于无淋巴结转移(31.8%,P<0.05)。Westernblot及RT-PCR结果显示,胃癌组织和相应非癌胃粘膜组织中Caveolin-1的表达无显著性差异,但MGC-803和BGC-823细胞中Caveolin-1表达     

胃癌端粒酶活性及ras基因突变的研究

目的 检测胃癌及癌前病变组织、胃炎组织端粒酶活性及ras基因变异,了解胃癌发生的生物学特性。方法 应用TRAP法对32例胃癌、16例异形增生、13例肠上皮化生、8例萎缩性胃炎、12例浅表性胃炎进行端粒酶活性及ras基因变异的测定。结果 胃癌组织28例(87.5％)端粒酶表达阳性,ras基因变异27例(84.4％)阳性;异形增生阳性分别为4例(25.0％)和5例(31.3％);肠上皮化生阳性分别为4例(30.8％)和4例(30.8％);萎缩性胃炎阳性分别为1例(8.4％)和2例(16.7％);胃炎组织阳性分别为0和1例(8.3％)。端粒酶及ras基因阳性表达与胃癌的部位、分化度、是否有淋巴转移无关。端粒酶活化与ras基因密切相关。结论 端粒酶活化及ras基因变异均与胃癌发生有关,可为胃癌的诊断提供可靠的指标。     

根除HP感染对胃黏膜炎症和肠腺化生的影响

目的：探讨根除幽门螺杆菌（helicobacter pylori,HP）感染对胃黏膜炎症和肠腺化生（intestinal meta-plasia,IM）的意义。方法：随访119例10年前HP感染的患者,其中62例行根除HP治疗（治疗组）,57例中断治疗或仅接受对症治疗（对照组）,对比其前后HP感染情况、胃黏膜炎症及肠腺化生（IM）的变化情况。结果：10年后对照组中45/57例HP呈阳性（78.94%）;治疗组中15例HP呈阳性（24.19%）,胃炎活动性检出率明显减少与对照组持续HP感染者比较,差异有显著性（P〈0.01）,肠腺化生（IM）的程度也显著减轻（P〈0.05）。结论：HP感染与胃黏膜活动性炎症关系非常密切,根除HP可以减轻胃黏膜的炎症和肠腺化生（IM）程度。