肠上皮化生组织中CDX2表达及其与幽门螺杆菌感染的关系探讨

目的 探讨胃黏膜肠上皮化生组织中CDX2表达的临床意义及其与幽门螺杆菌(Hp)感染的关系.方法 采用免疫组织化学技术检测93例(其中正常胃黏膜7例,浅表性胃炎21例,萎缩性胃炎22例,萎缩性胃炎伴肠上皮化生43例)胃黏膜组织CDX2表达情况；使用14C尿素呼气试验检测Hp感染情况.结果 7例正常胃黏膜患者Hp检测阴性,Hp感染在萎缩性胃炎和萎缩性胃炎伴肠上皮化生中阳性率分别为77.27％(17/22)、65.12％( 28/43),显著高于浅表性胃炎的19.05％(4/21)(P＜0.0l).CDX2在正常胃黏膜及浅表性胃炎中无表达,在萎缩性胃炎伴肠上皮化生中阳性率83.72％( 36/43),显著高于萎缩性胃炎的40.91％(9/22)(P＜ 0.01).结论 Hp感染、CDX2表达与胃黏膜肠上皮化生有关,CDX2异常表达可能是启动胃黏膜上皮发生肠化的始动因素,检测胃黏膜组织中CDX2表达可以帮助临床识别胃黏膜肠上皮化生组织,预测胃癌前病变的进展,为临床选择治疗方案提供依据.

Relationship between expression of CDX2 in intestinal metaplasia of stomch and Helicobacter pylori infection

Objective To investigate the expression of CDX2 and its clinical significance in gastric intestinal epithelial tissue,and investigate the relationship between expression of CDX2 and infection of Helicobacter pylori.Methods The expression of CDX2 was studied by immunohistochemical technique in 93 cases of gastric mucosa (including 7 cases of normal gastric mucosa,21 cases of superficial gastritis,22cases of atrophic gastritis,43 cases of atrophic gastritis with intestinal metaplasia).14C urea breath test was used to detect the Helicobacter pylori infection.Results Helicobacter pylori was negative in 7 cases of normal gastric mucosa,the positive rate of Helicobacter pylori infection in atrophic gastritis and atrophic gastritis with intestinal metaplasia was 77.27％ (17/22),65.12％ (28/43),significantly higher than that of superficial gastritis 19.05％(4/21 )] (P ＜0.01 ).No expression of CDX2 was observed in normal gastric mucosa and superficial gastritis.The positive rate of CDX2 in atrophic gastritis with intestinal metaplasia was 83.72％(36/43 ),which was higher than that in atrophic gastritis 40.91％(9/22)](P＜ 0.01 ).Conclusions The infection of Helicobacter pylori and the expression of CDX2 are significantly associated with intestinal metaplasia.The abnormal expression of CDX2 might be the origin of intestinal metaplasia.The detection of gastric mucosa of CDX2 expression can be used to identify the intestinal metaplasia of gastric mucosa,predict the progress of gastric precancerous lesions,and provide a basis for the selection of treatment program.