In vitro synthesis of SIgA and CEA and their relationship in gastric cancer tissue

The in vitro synthesis of secretory immunoglobulin A (SIgA) and carcinoembryonic antigen (CEA) was observed by tissue culture of biopsied gastric cancer tissue and gastric mucosa in other gastric diseases. The level of SIgA Synthesis in cultured gastric cancer tissue was lower than that in gastric mucosa in chronic atrophic gastritis, chronic superficial gastritis and normal stomach. The gastric mucosa of chronic gastritis can produce more SIgA than the normal gastric tissue, but the difference between chronic atrophic gastritis and chronic superficial gastritis was of no statistical significance. The CEA level was significantly higher in cancerous tissue than that in noncancerous ones, the amount of CEA synthesis by gastric mucosa in chronic atrophic gastritis was higher than that in chronic superficial gastritis and normal stomach. Well differentiated adenocarcinoma secreted much more SIgA and CEA than the poor-differentiated ones. The results suggest that the estimation of secretory function of SIgA and CEA be helpful for clinical diagnosis of gastric cancer.     

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。     

Carcinoembryonic antigen and immunoglobin in gastric juice in the diagnosis of gastric cancer

Levels of carcinoembryonic antigen (CEA) and immunoglobin (Ig) in gastric juice of 93 patients with benign and malignant gastric diseases were assayed. The CEA level in gastric cancer patients (55.73 +/- 38.26 ng/ml) was obviously higher than that in peptic ulcer (15.51 +/- 12.09 ng/ml) and superficial gastritis (26.96 +/- 20.17 ng/ml). But no significant difference was found between the CEA levels of gastric cancer and chronic atrophic gastritis (48.66 +/- 31.87 ng/ml). Also, elevated CEA was closely correlated to intestinal metaplasia. The positive rate of Ig was significantly higher in gastric cancer (IgG greater than or equal to 185 ug/ml, IgA greater than or equal to 100 ug/ml) than in benign gastric diseases. Although no correlation is present in the CEA and Ig in gastric juice, the combination of these two methods could improve the diagnostic accuracy. We believe that the two assays are worthy for screening gastric cancer from patients with high risk, and for identifying precancerous lesions.     

454例自然人群的3432份胃粘膜活检观察

自胃癌高发区454例自然人群的3432份胃粘膜活检,检出胃癌5例,慢性浅表性胃炎(CSG)67.28％,慢性萎缩性胃炎(CAG)3.88％,肠上皮化生(IM)14.28％。CSG在胃体部高于窦部,CAG与IM则胃窦部明显高于体部(P<0.05)。支持CAG、IM为癌前状态之观点。     

An endogastric capsule for measuring tumor markers in gastric juice: an evaluation of the safety and efficacy of a new diagnostic tool.

BACKGROUND: In gastric juice, high levels of the carcinoembryonic antigen (CEA) and the carbohydrate antigen 19-9 (CA 19-9) have been found to correlate with precancerous lesions and gastric cancer. So far, sampling of gastric juice has required upper endoscopy. In place of this invasive procedure, we investigated a new tool for the quantitation of tumor markers in gastric juice. MATERIALS AND METHODS: The study population consisted of healthy controls and consecutive subjects with suspected gastric cancer or dyspepsia/epigastric distress. Patients were asked to swallow a small gelatine capsule (14 mm in length and 5 mm in diameter) containing a pierced plastic cover and surrounding a piece of absorbent paper. The capsule was left in the gastric cavity for 60 min to allow saturation of the absorbent paper with gastric juice. A 45-50 cm length of nylon thread connected to the inner capsule was used to remove the device from the gastric cavity. After processing the absorbent paper for radioimmunoassay, CEA and CA 19-9 levels were correlated to the findings of upper endoscopy and biopsies of gastric mucosa or suspected lesions. RESULTS: The endogastric capsule did not cause any side-effects and 62 participants were fully compliant to the procedure. Assessable gastric juice samples were taken from 23 patients with gastric cancer, 15 patients with intestinal metaplasia or dysplasia, 12 patients with gastritis and 12 controls without gastric diseases. In the 12 samples of gastric juice from control patients, mean values of CEA and CA 19-9 were 1.1 +/- 0.9 ng/ml and 16 +/- 7.5 ng/ml, respectively. The mean levels of both markers were found to increase according to the severity of gastric lesions and in patients with cancer, mean CEA and CA 19-9 levels were 513 +/- 627 ng/ml and 545 +/- 510 ng/ml, respectively. Patients with precancerous lesions and cancer showed higher levels of CEA and CA 19-9 than patients with normal findings or gastritis (P <0.001). CONCLUSIONS: The endogastric capsule is a simple, non-invasive tool for the measurement of CEA and CA 19-9 levels in gastric juice. These values may discriminate between normal or minor pathologic changes and precancerous lesions or carcinomas. Further investigations are warranted, since this may represent a new method for gastric cancer screening.     

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。     

Expression of Cdx2 and claudin-2 in the multistage tissue of gastric carcinogenesis

In this paper, we investigated Cdx2 and claudin-2 expression in pathological paraffin tissues of sinus ventriculi from gastroscopic biopsy to determine the correlation between the expressions of these 2 genes during gastric carcinogenesis by immunochemical ABC technique. Altogether, we analyzed 108 chronic superficial gastritis, 55 chronic atrophic gastritis, 109 intestinal-type metaplasia, 93 dysplasia and 52 gastric intestinal-type adenocarcinoma samples. Our results indicated that the percentage of Cdx2-positive cases was 0% (0/108) for chronic superficial gastritis, 0% (0/55) for chronic atrophic gastritis, 90.83% (99/109) for intestinal-type metaplasia, 51.61% (48/93) for dysplasia and 61.54% (32/52) for gastric intestinal-type adenocarcinoma, primarily expressed in the cell nucleus and partly in the cytoplasm (p < 0.05); interestingly, the percentage for the intestine-type metaplasia was markedly high. The percentage of claudin-2-positive cases was 0% (0/108) for chronic superficial gastritis, 0% (0/55) for chronic atrophic gastritis, 0% (0/109) for intestinal-type metaplasia, 35.48% (33/93) for dysplasia and 71.15% (37/52) for gastric intestinal-type adenocarcinoma, primarily in the cell membrane and gradually increased in the multistage process of gastric carcinogenesis (p < 0.05). Significant correlations were found between claudin-2 and Cdx2 protein expression in dysplasia and intestine-type adenocarcinoma (r = 0.112, p < 0.05). Thus, there may be a correlation between the expression of claudin-2 and Cdx2 in stages of dysplasia and cancer.     

Carcinoembryonic antigen, CA 19-9, and CA 125 in normal and carcinomatous human colorectal tissue

In 115 primary colorectal carcinomas and 64 normal colorectal mucosa specimens the concentrations of carcinoembryonic antigen (CEA), CA 19-9, and CA 125 were measured. The determinations were performed in cytosols by use of radioimmunometric and enzymeimmunometric assays and related to the wet tissue weight. In the cancer tissue the CEA levels ranged from 5.5 to 1990 micrograms/g tissue and were significantly higher (P less than 0.0001) than those found in the normal mucosa (1.2-58.6 micrograms/g). The CA 19-9 content in carcinoma specimens (120-72660 U/g) was also significantly higher (P = 0.011) than in the normal mucosa (37-5800 U/g). In contrast, no significant difference of the CA 125 concentrations between the normal and the cancer tissue was found. The relative operating characteristic (ROC) curves for the three markers corroborate CEA as the marker superior to CA 19-9. On the other hand is shown that CA 125 is completely unable to discriminate between normal and cancer tissues. A decreasing CEA tissue concentration and an increasing dedifferentiation of colorectal cancers were significantly (P = 0.018) related with each other. Higher tumor stages implied significantly higher tissue marker values of CA 19-9 (P = 0.027) and CA 125 (P = 0.0008). The findings correspond quite well with serum examinations of the three markers which have been reported earlier.     

p27和ILK在胃癌及癌前病变中的表达及意义

目的:探讨p27和ILK在胃癌及癌前病变中的表达及其与胃癌病理参数之间的关系. 方法: 用免疫组化技术(SP法)对正常胃黏膜(normal gastric mucosa,NGM)、慢性浅表性胃炎(chronic superficial gastritis,CSG)、慢性萎缩性胃炎(chronic atrophia gastritis,CAG)伴肠上皮化生、慢性萎缩性胃炎伴非典型增生各20例和胃癌(gastric carcinoma,GC)60例标本进行免疫组织化学染色,分析p27和ILK的表达与胃癌临床和病理的关系. 结果: p27和ILK表达阳性率分别为:NGM组100%和5%,CSG组85%和10%,CAG伴肠化组70%和20%,CAG伴非典型增生组45%和30%,胃癌组38.3%和40%.胃癌组和CAG伴非典型增生组p27阳性率显著低于其他组(P＜0.05),ILK阳性率则显著高于其他组(P＜0.05).p27和ILK在胃癌中的表达与肿瘤分化程度、浸润深度及肿瘤临床分期相关,p27蛋白的表达还与有无淋巴结转移相关.p27和ILK在胃癌中的表达呈显著负相关(r=-0.768,P＜0.05). 结论: 检测胃癌组织中p27和ILK的表达有助于判断肿瘤的进展程度,两者联合检测有助于判断肿瘤预后.     

Prognostic value of carcinoembryonic antigen, CA 19-9 and CA 72-4 in gastric carcinoma.

The prognostic value of preoperative serum levels of carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in patients with gastric cancer. Eighty-two patients who underwent surgical resection of gastric cancer were entered in the study. Correlation analyses showed that CA 72-4 was more frequently positive in patients with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was more frequently positive in patients with advanced tumors (p = 0.01) and with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal involvement (p = 0.02). CEA was more frequently positive in patients with liver metastasis (p = 0.03). Low 3-year cumulative survival was significantly associated with elevated serum levels of CA 72-4 (p = 0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA 72-4 provided prognostic information in the multivariate analysis. Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher risk of death than patients with low levels of the marker. Our results suggest that CA 72-4 has prognostic value in gastric cancer, and patients with a high preoperative serum level of CA 72-4 have a greater risk of death due to gastric cancer.     

Disturbed metabolism of gastric mucosa DNA precursors as prognosticator of neoplastic transformation of gastric ulcer

Levels were assayed and compared of metabolic enzymes--thymidine and adenosine--in gastric mucosa tissues and blood serum from patients with gastric ulcer disease and gastric cancer (age--30-60 yrs). Enzymatic levels matched to the highest degree in cases of ulcer disease aggravated by chronic atrophic gastritis and precancerous alterations (dysplasia, metaplasia). Elevated concentrations of thymidine kinase and phosphorylase and adenosine desaminase were identified both at foci of ulceration (p > 0.001, p > 0.05, respectively) and in blood serum in all age brackets. Moreover, blood serum assay confirmed the view that changes in serum enzyme levels are suggestive of those in tissue enzymatic profile. Our data established a direct correlation between accumulated effect of level changes, on the one hand, and risk of neoplastic transformation of gastric mucosa in ulcer patients, on the other.     

Carcinoembryonic antigen and CA19-9: implications of quantitative marker measurement in tissues for prognosis of colorectal cancer.

Measurement of tumor markers in serum of colorectal cancer patients after surgery is a sensitive method in early diagnosis of systemic spread of tumor cells. Moreover, prognostic association of carcinoembryonic antigen (CEA) content in serum at the time of surgery is well known. However, fairly unclear is whether quantitative content of CEA and CA19-9 in cancer tissue and adjacent normal mucosa of colorectal cancer patients is correlated to prognosis. Concentrations of CEA and CA]9-9 were analyzed simultaneously in serum, cancer tissue, and normal colonic mucosa of 41 colorectal cancer patients operated for cure. Follow-up data were available for up to 82 months (median, 47 months) after surgery. During the follow-up period, 20 patients had a tumor recurrence, and all these patients died of metastatic disease. Using the median concentration of CEA and CA19-9 in tissues as a cut-off, no difference in overall and disease-free survival was observed between patients with elevated or normal CEA or CA19-9 concentrations in tumor tissue. However, in adjacent histologically normal mucosa, elevated CEA content was associated with significantly shorter overall survival (P = .0385) and disease-free survival (P = .0141) but not CA19-9 content. Despite the unknown biological function of tumor markers in malignant disease, measurement of tumor-associated antigens in colorectal tissues can become an interesting prognostic marker.     

Levels of nitrite, nitrate, N-nitroso compounds, ascorbic acid and total bile acids in gastric juice of patients with and without precancerous conditions of the stomach

To determine the relevance of gastric juice factors to gastric carcinogenesis, 56 patients with unoperated stomachs undergoing endoscopy for dyspepsia had gastric juice aspirated and analysed for pH, ascorbic acid, total bile acids, nitrite, nitrate and total nitroso compounds (NOCs). Plasma was obtained for vitamin C estimation. Antral and body biopsies were assessed for gastritis, Helicobacter pylori, atrophy and intestinal metaplasia (IM). Patients with chronic atrophic gastritis (n = 17) had lower gastric juice ascorbic acid concentrations (P less than 0.001), higher pH (P less than 0.05) and higher incidence of H. pylori infection (P less than 0.001) than normal subjects (n = 12). Patients with reflux gastritis (n = 9) had higher total bile acids (P less than 0.01). Patients with chronic gastritis and IM (n = 11) had higher gastric juice pH (P less than 0.01) and total bile acid concentrations (P less than 0.05), and lower gastric ascorbic acid concentrations (P less than 0.01) than those with chronic gastritis and no IM (n = 24). In chronic gastritis, high nitrite concentrations were associated with high pH (P less than 0.01). However, there were no significant differences in plasma vitamin C or gastric nitrite, nitrate or total NOC concentrations in relation to gastric histology. We conclude that the premalignant condition IM is associated with H. pylori infection, low gastric ascorbic acid levels and elevated total bile acids, but not to elevation in nitrite or total NOCs in fasting gastric juice.     

Antigen MG7 in gastric cancer and gastric precancerous lesions

Earlydetectionandearlydiagnosisofgastriccancerareessentialtodecreasethemortalityandincreasesurvivalrateofgastriccancer.TheZhuangheregioninLiaoningProvinceisahighriskareaofgastriccancerandanimportantresearchbaseforgastriccancerpreventionandtreatmentinChina[1].AlargescalescreeningofgastriccancerinthisareawascarriedoutbytheCancerInstituteofChinaMedicalUniversitypreviously.Inthepresentstudy,thegastricmucosasamplesfromthescreeningwereusedtoinvestigatethedynamicexpressionofgastriccancer-associat…     

p27蛋白及cyclin B1在慢性胃病及胃癌患者胃粘膜中的表达及其临床意义

目的 研究p27蛋白及cyclin B1在慢性胃病及胃癌患者胃粘膜组织中的表达水平,探讨p27蛋白及cyc-lin B1的表达与胃癌演变的关系.方法 采用免疫组织化学SP法,检测慢性非萎缩性胃炎、慢性萎缩性胃炎、肠上皮化生、非典型增生及胃癌患者胃粘膜组织中p27与cyclin B1的表达水平,并进行临床分析.结果 在慢性非萎缩性胃炎、慢性萎缩性胃炎、肠上皮化生、非典型增生、胃癌的演变过程中,p27蛋白表达水平呈现逐级降低的变化规律,cyclin B1表达水平呈现逐级升高的变化规律,两者的变化呈负相关.结论 p27蛋白及cyclin B1在胃粘膜中的表达水平与慢性胃病、胃癌前病变、胃癌的发生发展有关,其在胃癌的演变过程中起着重要的作用.     

血清碱性磷酸酶、癌胚抗原、糖类抗原19-9联合检测对胃癌骨转移的诊断价值

目的探讨碱性磷酸酶(ALP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)单独与联合检测对胃癌骨转移的诊断价值,为胃癌骨转移的早期诊断提供依据。方法收集522例胃癌患者的临床资料及血清标志物(ALP、CEA、CA19-9)检测结果,根据有无骨转移将入组患者分为骨转移组(n=91)和无骨转移组(n=431)。参照Soloway分级标准将骨转移分为3级,进一步分析ALP、CEA、CA19-9三者单独与联合检测在胃癌骨转移中的诊断价值及其与骨转移分级之间的关系。结果骨转移组患者ALP、CEA、CA19-9水平均明显高于无骨转移组,差异均有统计学意义(P﹤0.01)。ALP、CEA、CA19-9均是胃癌发生骨转移的影响因素(P﹤0.05)。3种血清标志物联合检测的曲线下面积(AUC)大于任何指标单独检测,但ALP单独检测与三者联合检测的AUC值差异不明显;3种血清标志物联合检测诊断效能优于单独检测。ALP与CA19-9水平随着骨转移分级升高呈上升趋势。经Spearman相关分析显示,ALP、CA19-9与骨转移分级均呈正相关(r=0.436、0.391,P﹤0.05),且ALP在评价胃癌骨转移严重程度方面优于CA19-9。结论ALP、CEA、CA19-9联合检测对胃癌骨转移的诊断价值优于单项检测,为胃癌骨转移的早期诊断以及监测提供参考。但考虑到患者的经济因素,对于临床上怀疑胃癌骨转移的患者,ALP是首选的检测指标,且该指标可作为评价胃癌骨转移严重程度的生物学标志物。     

胃粘膜组织中CEA含量的研究及其临床意义探讨

 我们应用ABC免疫组织化学技术对306例活检的胃粘膜组织进行了CEA含量的测定，结果显示：非萎缩性，萎缩性胃粘膜及胃癌组织中CEA检出阳性率分别是77.22%,86.47%,94.68%.在非萎缩性胃粘膜，萎缩性胃粘膜及胃癌组织中都有一定的CEA阳性显示率。CEA对定性诊断意义不大，但在阳性强度表达上有明显差别（P<0.01）,以胃癌明显。CEA阳性强度等级相关分析也显示CEA含量与胃癌及萎缩性胃炎病变程度是极明显的正相关（R>0.7）.CEA的测定对监测萎缩性胃炎的预后有一定价值。     

Ectopic expression of guanylyl cyclase C and endogenous ligand guanylin correlates significantly with Helicobacter pylori infection in gastric carcinogenesis

The molecular mechanisms leading to gastric carcinogenesis still remain unclear. Recently, several studies demonstrated that over-expression of guanylyl cyclase C (GCC) has been detected in intestinal-type gastric cancer (GC) and precursor lesions. Our objective was to explore the expression levels of GCC and endogenous ligands guanylin (GN) and uroguanylin (UGN) and the correlation between Helicobacter pylori (H. pylori) and GCC, GN, and UGN expressions in patients at different stages from normal mucosa to superficial gastritis, atrophic gastritis, intestinal metaplasia (IM), dysplasia, and finally adenocarcinoma. The expression of GCC and GN was absent in the distal normal gastric tissues and superficial gastritis in all cases, whereas they were measured in IM, dysplasia, and GC. The expression of GCC and GN was closely related to intestinal-type GC. From superficial gastritis to gastric carcinomas, the H. pylori positive rate was 19.7, 33.3, 69.6, 80.0, and 82.1%, respectively. The positive correlation was found between GCC and GN in IM, dysplasia, and GC. Also, the positive correlation was found between GCC, GN, and H. pylori infection in them. These results demonstrate that the detection of GCC and GN will be beneficial to diagnosis human gastric carcinoma and precancerous lesions. Ectopic expression of GCC and GN in human gastric mucosa and H. pylori infection may play an important role in the carcinogenesis of the intestinal-type GC.     

良性胃黏膜病变中Hp感染与Livin、Ki-67表达关系的研究

目的：观察Livin和Ki-67在Hp（＋/-）良性胃黏膜病变组织中的表达。方法：所有胃黏膜病变组织均来自内镜活检及手术切除标本,良性胃黏膜病变组织标本144例。采用免疫组化法测定上述胃黏膜病变组织及胃癌组织中Livin、Ki-67的表达,用甲苯胺蓝染色检测Hp。结果：Livin、Ki-67在Hp根治前后从慢性浅表性胃炎、慢性萎缩性胃炎、伴肠化、不典型增生组织中的表达率呈递增趋势,其中在慢性萎缩性胃炎和萎缩伴肠化的阳性表达率有统计学意义（ P〈0.05）。结论：在癌前病变阶段根除Hp可使部分萎缩和肠化减轻,能有效治疗Hp相关性胃炎,也可预防Hp相关性胃癌的发生。     

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。