人胃癌相关抗原MG7在胃癌前病变组织中的表达及其与COX-2表达的相关性分析

目的:探讨人胃癌相关抗原MG7在胃癌前病变组织中的表达及其与COX-2表达的相关性.方法: 采用常规ABC免疫组化染色法联合检测334例胃癌前病变患者的胃黏膜中MG7抗原和COX-2抗原的表达情况.结果: 在胃癌前病变组织(包括肠上皮化生和不典型增生)中MG7-Ag和COX-2的表达阳性率分别为49.1%和56.6%,从慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、不典型增生到胃癌MG7-Ag和COX-2的表达均呈上升趋势,差异具有显著性(P<0.05).MG7-Ag和COX-2在胃癌前病变组织中表达具有相关性.结论: MG7-Ag和COX-2在胃癌前病变组织中有一定的相关性.     

胃癌及癌前病变细胞凋亡与Caspase-9,Bax表达的关系

目的:探讨细胞凋亡基因Caspase-9和Bax在胃癌前病变和胃癌发展中的作用.方法:应用免疫组化S-P法检测 Caspase-9和Bax在57例胃癌及48例非癌胃黏膜组织的表达,用原位末端标记法(TUNEL法)检测相应胃组织细胞凋亡.结果:Caspase-9蛋白在非癌胃黏膜组(慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、不典型增生)阳性表达率分别为 100.00%、86.67%、50.00%、42.85%,呈逐渐下降趋势.慢性浅表性胃炎组中Caspase-9蛋白阳性表达率与肠上皮化生、不典型性增生有显著性差异(P＜0.05),肠上皮化生组Caspase-9蛋白阳性表达率高于不典型增生组,但无统计学差异(P＞0.05).Bax蛋白在48例非癌胃组织中的阳性表达率分别为:慢性浅表性胃炎100.00%、慢性萎缩性胃炎80.00%、肠上皮化生56.25%、不典型增生57.14%,呈逐渐下降趋势,其中慢性浅表性胃炎组Bax蛋白阳性表达率与肠上皮化生、不典型增生有显著性差异(P＜0.05).慢性浅表性胃炎、慢性萎缩性胃炎 、肠上皮化生、不典型增生、胃癌组织中,AI值( 细胞凋亡指数)分别为(14.72±2.68)%、(10.02±2.34)%、(7.55±2.80)%、(6.09±2.35)%、(3.26±1.23)%,呈逐渐下降趋势,有显著性差异(P＜0.05).结论:Caspase-9和Bax可能参与胃癌癌前病变的形成,促进胃癌的发生.     

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.     

胃癌及癌前病变细胞凋亡与Caspase-9，Bax表达的关系

目的：探讨细胞凋亡基因Caspase-9和Bax在胃癌前病变和胃癌发展中的作用。方法：应用免疫组化S—P法检测Caspase-9和Bax在57例胃癌及48例非癌胃黏膜组织的表达,用原位末端标记法（TUNEL法）检测相应胃组织细胞凋亡。结果：Caspase-9蛋白在非癌胃黏膜组（慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、不典型增生）阳性表达率分别为100．00％、86．67％、50．00％、42．85％,呈逐渐下降趋势。慢性浅表性胃炎组中Caspase-9蛋白阳性表达率与肠上皮化生、不典型性增生有显著性差异（P〈0．05）,肠上皮化生组Caspase-9蛋白阳性表达率高于不典型增生组,但无统计学差异（P〉0．05）。Bax蛋白在48例非癌胃组织中的阳性表达率分别为：慢性浅表性胃炎100．00％、慢性萎缩性胃炎80．00％、肠上皮化生56．25％、不典型增生57．14％,呈逐渐下降趋势,其中慢性浅表性胃炎组Bax蛋白阳性表达率与肠上皮化生、不典型增生有显著性差异（P〈0．05）。慢性浅表性胃炎、慢性萎缩性胃炎、肠匕皮化生、不典型增生、胃癌组织中,AI值（细胞凋亡指数）分别为（14．72±2．68）％、（10．02±2．34）％、（7．55±2．80）％、（6．09±2．35）％、（3．26±1．23）％,呈逐渐下降趋势,有显著性差异（P〈0．05）。结论：Caspase-9和Bax可能参与胃癌癌前病变的形成,促进胃癌的发生。     

陕北胃癌高发区胃黏膜组织中MAD2的表达及意义

目的:研究MAD2在正常胃黏膜、胃病变黏膜组织中的表达,并探讨其与浅表性胃炎、萎缩性胃炎、不典型增生、胃癌之间的关系.方法: 应用免疫组织化学SP法检测219例不同胃组织标本中MAD2的表达情况,所有标本均经病理证实. 结果: MAD2在正常胃黏膜、浅表性胃炎、萎缩性胃炎、不典型增生、胃癌黏膜组织中的阳性表达率随病理学分类的不同而有差异.其中不典型增生、胃癌黏膜组织中MAD2的阳性表达率与其余各组MAD2的阳性表达率有明显的差异(P<0.05).结论: 胃病变组织中MAD2蛋白的异常高表达,对诊断不典型增生、胃癌有重要的参考意义.     

幽门螺杆菌感染的胃黏膜上皮细皮细胞环氧合酶-2表达及意义

目的探讨幽门螺杆菌(Hp)感染的胃黏膜上皮细胞环氧合酶-2(COX-2)的表达及其在胃黏膜癌变过程中的意义.方法采用快速尿素酶试验和组织学碱性品红染色法检测胃黏膜Hp 感染状况;应用免疫组化法检测胃黏膜上皮细胞COX-2表达状况.结果 32例胃癌中,COX-2表达阳性22例(68.7%).12例Hp阴性的胃黏膜中,有1例(8.3%)COX-2低表达;10例Hp阳性正常胃黏膜中,仅1例(10.0%)COX-2低表达;9例Hp阳性的胃黏膜充血水肿糜烂者中,有5例(55.6%)COX-2表达阳性,与Hp阴性者和Hp阳性正常胃黏膜者比较,差异有统计学意义(P<0.05);10例Hp阳性的轻度萎缩性胃炎伴轻度肠化生者中,COX-2表达阳性5例(50.0%);10例Hp阳性的中重度萎缩性胃炎伴中重度肠化生者中,COX-2表达阳性8例(80.0%);8例Hp阳性的中重度不典型增生者中,COX-2表达阳性6例(75.0%).中重度萎缩性胃炎伴中重度肠化生和不典型增生者的COX-2表达高于轻度萎缩性胃炎伴轻度肠化生者(P<0.05).结论 Hp感染诱导慢性浅表性胃炎黏膜上皮细胞的COX-2表达与黏膜损伤形成有关;根据胃癌发生模式,COX-2表达上调与Hp感染胃黏膜癌变发生相关,且可能在癌前病变形成早期阶段起作用.     

血清与组织中MG7抗原表达对胃癌前病变风险预测的临床意义

背景与目的:多年来,许多科研人员致力于探索诊断胃癌及癌前疾病的生物学标志物.本研究通过对不同类型胃黏膜活检组织胃癌相关抗原(MG7-Ag)的表达和血清MG7-Ag含量的检测,探讨两者的相关性及对胃癌前病变风险预报的临床应用价值.方法:125例胃黏膜活检组织及其血清标本(正常胃黏膜12例,浅表性胃炎21例,胃黏膜糜烂溃疡24例,萎缩性胃炎15例,异型增生22例,胃癌31例),采用SP免疫组织化学二步法染色检测胃黏膜标本中MG7-Ag的表达情况;采用酶联免疫吸附实验检测血清MG7-Ag的含量.结果:①MG7-Ag在12例正常胃黏膜中无表达,在31例胃癌中表达率为93.55%,由浅表性胃炎(14.29%)或胃糜烂溃疡(33.33%)进展至萎缩性胃炎(86.67%)或异型增生(81.82%)再进展至胃癌(93.55%),MG7-Ag表达率依次逐渐上升,差异有显著性(P<0.05).②血清MG7-Ag含量从浅表性胃炎(3.0±0.6)、胃黏膜糜烂溃疡(2.8±2.0)、萎缩性胃炎(3.8±1.2)/异型增生(3.9±1.7)到胃癌组(7.0±4.6)有升高趋势,并且各组间比较差异均有非常显著性(P<0.01).胃癌患者血清MG7-Ag含量明显高于其他胃病患者,差异有显著性(P<0.05).③从浅表性胃炎到胃黏膜糜烂溃疡进展至萎缩性胃炎/异型增生再进展至胃癌,随着其病变组织MG7-Ag原位表达的上升,其血清MG7-Ag浓度有上升趋势,并且各组间比较差异均有非常显著性(P<0.01).两者具有良好的相关性(rs=0.346,P=0.001).结论:①MG7-Ag在胃疾病的动态表达提示胃黏膜细胞恶性程度与MG7-Ag的表达呈正相关,血清MG7-Ag与组织MG7-Ag表达有良好的相关性.②临床有望将MG7-Ag作为胃癌前病变随访,进行癌变风险预测以及早期诊断胃癌的预警标志物.③以血清标本代替组织标本检测UMG7-Ag具有取材方便,患者依从性好等优点,便于临床推广应用.     

人端粒酶催化亚单位和c-myc蛋白在胃癌及癌前病变中的表达及意义

目的:探讨人端粒酶催化亚单位(human telomerase catalytic subunit,hTERT) 和c-myc蛋白在胃癌和胃癌前病变中的表达及意义.方法: 应用免疫组织化学技术检测71例慢性胃炎和胃癌中hTERT和c-myc蛋白的表达,其中慢性胃炎伴萎缩者18例,伴肠化生者16例,伴中、重度不典型增生者16例,胃癌21例.结果: hTERT 和 c-myc蛋白的表达率在胃癌组织中均高于不典型增生、肠化生和萎缩性胃炎组织(P<0.05);在不典型增生组织中均显著高于肠化生、萎缩性胃炎组织(P<0.05);在肠化生组织中均显著高于萎缩性胃炎组织(P<0.05).hTERT蛋白表达率在c-myc蛋白阳性患者中显著高于c-myc蛋白阴性患者(P<0.01).结论: hTERT与c-myc蛋白在胃癌发生发展过程中,均可能发挥重要作用,对胃癌的发生、发展起促进作用,c-myc表达增加可能是胃黏膜上皮细胞端粒酶激活的重要机制之一.     

胃癌、癌前病变组织中p53蛋白表达的临床意义

目的探讨胃癌及癌前病变组织中p53蛋白表达的临床意义.方法采用间接免疫荧光标记染色和流式细胞术,检测并比较10例正常胃粘膜、13例浅表性胃炎、10例肠上皮化生、11例不典型增生及16例胃癌组织中p53蛋白的表达水平.以DNA指数、增殖指数(PI)、荧光指数(FI)为分析指标.结果胃癌、不典型增生及肠上皮化生的FI值分别为1.866±0.096、1.143±0.060、1.050±0.074,与正常胃粘膜(0.602±0.077)比较,均有显著性差异(P＜0.05),与浅表性胃炎(0.898±0.052)比较,也有显著性差异(P＜0.05).胃癌组织的FI值高于不典型增生及肠上皮化生(P＜0.05).不典型增生组织p53蛋白阳性率为25.0%(2/8),胃癌为68.4%(13/19),在不典型增生及胃癌组织中,其异倍体的FI值、PI值和p53蛋白阳性率与二倍体者比较,均有显著性差异(P＜0.05).结论胃癌组织p53蛋白的表达水平高于癌前病变及正常胃粘膜组织;随病变向恶性转化,p53蛋白表达水平、PI值及异倍体率均增高.因此,检测p53蛋白表达水平对胃癌的诊断具有一定意义.     

胃癌和胃癌前病变中NHE1蛋白的表达及其意义

目的探讨NHE1蛋白在胃癌和胃癌前病变中的表达及意义。方法对收集的65例各类胃病标本的NHE1蛋白表达进行检测,高倍镜视野下阳性细胞数占视野10%以下视为阴性,10%以上视为阳性。结果在65例标本中,NHE1蛋白阳性表达率在正常胃黏膜中0%(0/10);异型增生20.00%(1/5);肠上皮化生23.08%(3/13);慢性萎缩性胃炎16.67%(2/12);胃癌80.00%(20/25)。胃癌与正常胃黏膜和各型胃癌前病变相比,差异具有统计学意义(P<0.01)。结论 NHE1在慢性萎缩性胃炎、肠上皮化生、异型增生中的表达不断上调,在胃癌组织中NHE1蛋白超表达;NHE1可能是肿瘤治疗的一个有效的靶点。     

Advanced gastric carcinoma simulating early gastric carcinoma

Eighty-six cases of advanced gastric carcinoma simulating early gastric carcinoma were studied clinicopathologically. Cytophotometric DNA analysis was also performed in 33 cases. Most of these particular carcinomas were of the depressed type on gross inspection. Histologically, the tumors were of diffuse type in 60%. The rate of the carcinomas restricted to within the muscularis propria was 48% and high in comparison with those in conventional advanced gastric carcinomas. There were four main growth patterns: small invasion type (Type A, 43 cases), ulcer-connected type (Type B, 19 cases), vessel permeation type (Type C, six cases), and diffusely infiltrative type (Type D, 13 cases). There was a relationship between growth patterns, lymph node metastasis, and prognosis: Types A and B had a small percentage of lymph node metastasis and a good prognosis, whereas Types C and D a high percentage and a poor prognosis. DNA analysis revealed that two thirds of the examined cases showed a low ploidy pattern. The DNA ploidy patterns were concerned with the tumor growth pattern: high-ploidy cases were rarely seen in Types A and B yet were frequent in Types C and D. The 5-year survival rate was 73%, but results were poor in cases of tumors with blood vessel permeation, in those with lymph node metastasis, in those with the Type D or C growth patterns, and in those with high DNA ploidy pattern. Since these carcinomas can be understaged endoscopically and by gross examination, a precise study of the surgically excised tissues will aid in making an accurate prognosis.     

胃神经内分泌癌与胃神经内分泌瘤及胃腺癌的CT特征及鉴别

目的 探讨胃神经内分泌癌(G NEC)与胃神经内分泌瘤(G NET)及胃腺癌(G ADC)的CT特征,为临床诊治提供参考。方法 选取2014年1月至2018年9月于南京医科大学第一附属医院老年消化科就诊的G NEC、G NET及G ADC患者各15例，分别为G NEC组、G NET组及G ADC组，对多个CT特征进行评估,以鉴别G NEC与G NET及G ACD的影像学差异。结果 3组中存在差别的CT特征有肿瘤最大径(P=0023)、肿瘤位置(贲门、胃底及胃体为上部,胃体中下部及胃窦为下部, P=0020)、病灶数量(单发、多发及散发,P=0003)、肿瘤边缘是否清晰(P<0001)、黏膜是否完整(P<0001)、淋巴结是否转移(P<0001)、转移淋巴结最大径(P=0008)和有无淋巴结的坏死(P=0006);随后进行G NEC与G NET两组间比较,经单因素分析发现G NEC的病灶更大［(472±173)cm比(208±102)cm,P<0001)］,位于胃体中下部及胃窦的概率更高(600％ 比 133％, P=0021),单发病例更多(100％ 比667％, P=0042),更易发生淋巴结转移(933％ 比 200％,P=0001)。G NEC和G ADC两组间的CT特征的单因素分析显示,G NEC的转移淋巴结直径比G ADC的大［(182±069)cm 比(123±065)cm,P=0045］,G NEC的肿瘤边缘较G ADC清晰(600％ 比0, P=0001), G NEC的肿瘤黏膜较G ADC肿瘤黏膜完整(533％ 比667％, P=0014)。结论 CT的特征有助于G NEC与G NET及G ADC的诊断。     

Early gastric cancer mimicking advanced gastric cancer.

The clinicopathological features of 37 early gastric cancers mimicking advanced gastric cancer were reviewed retrospectively, and were compared with 596 other early gastric cancers and 126 mp gastric cancers, defined as gastric cancer invading the muscularis propria of the stomach. A greater tumour size (P < 0.005), submucosal invasion (P < 0.005), lymph node and lymph vessel invasion (P < 0.005) and vascular invasion (P < 0.025) were found more frequently in early gastric cancers mimicking advanced gastric cancers than in other early gastric cancers. There were no significant differences in the clinicopathological findings between early gastric cancers mimicking advanced gastric cancers and mp gastric cancers. Patients with early gastric cancers mimicking advanced gastric cancers showed a lower survival rate than patients with other early gastric cancers, but a higher survival than those with mp gastric cancers. The macroscopic appearance of an advanced gastric cancer was an indicator of massive submucosal invasion and lymph node metastasis in early gastric cancer. As early gastric cancers mimicking advanced gastric cancers showed similar clinicopathological findings to mp gastric cancers, these cancers should be treated as mp gastric cancers.     

A rare gastric neoplasm: gastric medullary carcinoma

A 57-year-old female patient with early stage gastric medullary carcinoma is presented with review of the literature.     

Metachronous gastric MALT lymphoma and early gastric cancer

In a recent paper published in this journal, Copie-Bergman etal. [1] presented four cases of metachronous early gastric cancerdeveloping after gastric MALT lymphoma. In these patients, theyfound (minimal) residual lymphoma in all surgical specimens,suggesting that such patients might have an increased risk     

胃淋巴瘤与胃腺癌的临床病理对比研究

目的 对比研究原发性胃淋巴瘤(primary gastric lymphoma,PGL)与胃腺癌(gastric adenocarcinoma,GA)临床及病理特征,以期增进对该疾病的临床诊治.方法 对49例原发性胃淋巴瘤和200例胃癌患者比较其年龄、发病时间、临床症状、肿块部位、内镜及大体分型、幽门螺杆菌(Helicobacter pylori,Hp)感染及组织病理学等临床资料,并详细分析12例早期胃淋巴瘤的临床病理资料.结果 49例PGL和200例GA组患者,均表现为腹痛、腹部不适和上消化道出血等非特异性症状.PGL多发于胃体及胃窦,病灶常为多发溃疡或巨大结节,GA组病灶以胃窦部为主,常呈单发溃疡;PGL组的Hp感染率显著高于胃癌组(P＜0.05);PGL术前诊断率显著低于GA组(P＜0.05).12例早期PGL患者中,8例为Ⅱc型病变,治疗效果较好.结论 内镜检查示胃黏膜有多发糜烂溃疡时,应考虑PGL可能.早期PGL确诊后通过手术、化疗或根除Hp治疗,预后良好.     

Sonic hedgehog expression in gastric cancer and gastric adenoma

Hedgehog protein is essential to gastrointestinal tract development, and disruption of the hedgehog signaling pathway is associated with gastrointestinal tumorigenesis. Here, we analyzed the degree of hedgehog expression in gastric cancer and precancerous tissue. From August 2005 to May 2006, 52 gastric cancers and 16 gastric adenomas were obtained from surgically or endoscopically resected specimens. Immunohistochemical staining using sonic hedgehog (Shh) antibody was performed in cancerous and noncancerous tissue portions. Hedgehog expression was assessed based on the summed scores of the intensity and proportion of Shh staining. According to Lauren's classification, Shh expression was stronger in the intestinal type than in the diffuse type (p<0.001). Although Shh expression was not related to the location, size, metastatic status, or mucin phenotype of the gastric cancer, the expression was stronger in the tubular type of gastric cancer than in the mucinous and signet-ring cell types (p=0.001). Shh expression was stronger in gastric adenoma than in the diffuse-type gastric cancer (p<0.001), but revealed no difference with that of the intestinal-type gastric cancer (p=0.30). Shh expression was strongest in all types of intestinal metaplasia of noncancerous tissues. Shh expression is related to the intestinal type of gastric cancer. The stronger Shh expression in intestinal metaplasia and gastric adenoma indicates that hedgehog protein is involved at an early phase of gastric carcinogenesis.