Hp感染与胃癌及癌前病变中p53、bcl-2、c-myc基因表达关系的研究

目的：研究幽门螺杆菌（Hp)感染的胃癌及癌前病变患者胃粘膜p53,bcl-2,c-myc基因的表达，以探讨Hp在胃癌发生，发展过程中的作用机制，方法：应用免疫组化方法测定60例胃癌组织，18例异型增生，29例肠上皮化生，35例萎缩性胃炎，29例浅表性胃炎组织中Bcl-2,c-myc基因蛋白表达情况，PCR／SSCP测定p53基因第5－8外显子突变，Hp阳性由快速尿素酶法和HE染色确定，结果：胃癌组Hp阳性41例，阴性19例，在胃癌组织中p53,bcl-2,c-myc基因阳性表达分别为38例（63．3％），38例（63．3％），18例（30．0％），p53,c-myc基因在胃癌中阳性表达率显著高于异型增生（P＜0．05）,bcl-2在异型增生组织中的阳性表达率与胃癌，肠上皮化生相比无显著性差异（P＞05），p53,bcl-2,c-myc基因表达与胃癌分期，淋巴结转移均无显著性关系（P＞0．05），但bcl-2与胃癌类型，分化程度显著相关（P＜0．05），每一种病变类型Hp阳性组p53,bcl-2,c-myc基因蛋白的阳性表达率均高于Hp阴性组，两者之间有显著性差异（P＜0．05），结论：Hp感染者具有更多肿瘤生物学行为，可以引起抑癌基因p53第5－8外显子突变，癌基因c-myc，凋亡调节基因bcl-2表达增加,Hp可能为促癌剂，在胃癌的发生发展中起一定作用。

Relationship between Helicobactor Pylori Infection and the p53 bcl-2 c-myc expressions in Gastric Cancer and Precancerous Lesions

Objective:To study the expression of tumor suppressive gene,regulatory gene of apoptosis and oncogene in gastric mucosa lesions of gastric cancer patients with Helicobacter pylori infection(Hp).Methods:Immunohistochemical staining was used to detect the expression of bcl-2,c-myc protein in60cases of gastric cancer,18dysplasia,29internal metaplasia,35at-rophic gastritis,29superficial gastritis.Exon5-8in the same tissues were detected by PCR,laser screen,PCR/SSCP.HP was assessed by using the rapid urease staining test combined with HE staining test.Results:There was no significant correlation for HP infection rate between gas-tric cancer and atrophic gastritis.The positive rate of p53,c-myc protein in gastric cancer was sig nificantly higher than that in dysplasia(P<0.05).The positive rate of bcl-2was not correlated between gastric cancer,intestinal metaplasia and dysplasia(P>0.05)but significantly higher than that in gastritis(P<0.05).Then expression rate of p53,bcl-2,c-myc in gastric can cer were38,(63.3%),38(63.3%),18(30.0%)respectively.No correlation between p53,bcl-2,cmyc and grade of pathologic stage,lymph node sta tus was ob served(P>0.05).There was sig nificant correla tion between bcl-2and type of gastric can cer,grade of differentiation(P<0.05).The expression rate of p53,bcl-2,c-myc in Hp positive group was higher than that in Hp neg ative group in same gas-tric disease.Conclusion:Hp might act as a tumor promoter in the gen esis of gastric cancer.