ras、c—erbB—2癌基因蛋白在胃癌及其癌旁组织中的表达及分布特征

目的 探讨不同组织学类型胃癌及其癌旁黏膜不同上皮细胞中ras、c-erbB-2癌基因蛋白的表达和分布特征，以及在胃癌组织发生学上的意义。方法 应用免疫组化ABC法，对46例胃癌及其癌旁黏膜组织中，鼠抗人单克隆抗体ras基因p21、兔抗人c-erbB-2原癌基因产物多克隆抗体p185蛋白进行检测。结果 不同组织类型胃癌及其癌旁伴随病变上皮细胞显示，p21、p185蛋白有不同的分布特征。高、低分化腺癌中，p21、p185蛋白的表达率在癌组织和癌旁肠化生上皮、异型增生上皮均有较高的表达，两者无显著性差异（P＞0.05），而癌旁形态学显示正常的黏膜中p21、p185蛋白表达率很低或无表达，与癌组织有显著差异（PM＜0.05）。p21、p185蛋白在印戒细胞癌、黏液腺癌、未分化癌的癌 癌旁形态学显示正常黏膜中均有较高表达或表达率接近，无显著性差异（P＞0.05）。结论 从基因表达水平提示胃高、低分化腺癌与癌旁肠化生上皮、异型增生上皮具有某些相同的改变，印戒细胞癌、黏液腺癌、未分化癌与癌旁黏膜腺上皮、黏液腺异常分化具有相同的改变。认为胃黏膜上皮肠化、异型增生以及胃腺颈部干细胞异常分化等多种细胞的基因改变，是向不同组织类型胃癌发展的基础。

Expression of rasp21 and c-erbB-2 in gastric carcinoma and adjacent gastric mucosa

Objective To investigate the expression and localization of rasp21 and c erbB 2 in different types of gastric carcinoma and their adjacent mucosa. Method Immunohistochemical staining was used to detect the expression of rasp21 and c erbB 2 in 46 cases of gastric carcinoma and their adjacent mucosa. Results Both the carcinoma and precancerous lesions (intestinal metaplasia and dysplasia) displayed strong reactivities with rasp21 and c erbB 2. On the contrary, there was low or no expression in peri cancerous gastric mucosa with grossly normal appearance ( P <0.05). Over expression of rasp21 and c erbB 2 was found in signet ring cell carcinoma, mucinous adenocarcinoma and undifferentiated carcinoma, as well as their adjacent mucosa. There was no difference in the expression of the two oncoproteins between the above types of carcinoma and their adjacent mucosa ( P >0.05). Conclusions Well and poor differentiated carcinomas and their adjacent mucosa with dysplasia and intestinal metaplasia bear the identical pattern of rasp21 and c erbB 2 expression. It is suggested that genetic alterations in many gastric lesions, such as dysplasia, intestinal metaplasia and abnormal differentiation of the stem cell in glandular neck, might play an important role in the pathogenesis of different types of gastric carcinoma.