胃癌与癌前病变中生物标志物表达的变化和临床意义

目的研究胃癌、胃黏膜不典型增生、肠化生、慢性胃炎和正常胃黏膜组织中C—myc和p21^WAF1蛋白的表达，以探讨C—myc和p21蛋白在胃癌发生、发展过程中的作用。方法采用免疫组化S-P法检测109例胃癌组织、30例不典型增生、33例肠化生、22例胃炎组织和35例正常胃黏膜组织中C～myc和p21蛋白的表达水平，并分析其临床意义。结果C—myc蛋白在正常胃黏膜、慢性胃炎、肠化生、胃黏膜不典型增生和胃癌组织中的表达呈逐渐增加趋势。p21蛋白在不典型增生组织中表达最高，而在胃癌组织中的表达却较不典型增生组织降低。Cmyc的表达与胃癌病理类型、肿瘤大小、侵袭深度和临床分期密切相关（P〈0．05），而p21表达水平则只与肿瘤侵袭深度相关（P〈0．05）。结论C—myc和p21蛋白参与了胃癌的发生和发展过程，且C—myc可作为判断胃癌进展程度的生物学标志物。

The Change of the Expressions of Biomarker in gastric cancer and its related tissues and their clinical significance

Objective To study the expression of the alterations of C-myc and p21^WAF1 in normal gastric epithelial tissues（NL）, chronic gastritis（CAG）, intestinal metaplasia（IM）, atypical hyperplasia（AH）, and gastric cancer tissues（GC）, and to explore the possible role of C-myc and p21^WAF1 in the development and progression of gastric cancer. Method Using immunohistoehemical technique, we detected the expressions of C-myc and p21^WAF1 in 109 cases with gastric carcinoma, 30 cases with atypical hyperplasia, 33 cases with intestinal metaplasia, 22 cases with chronic gastritis and 35 normal gastric epithelial lesions and analyzed their clinical signi/ieance. Results We found that the expression of C myc was increasing along the sequence （NL-CAG-IM AH-GC）. In contrast to C-myc, expression of p21 was enbanced in atypical hyperplasia but decreased in carcinoma. In addition, we observed that expression level of C-myc was related to Lauren＇s typing, tumor size, invasion and clinical stage（P〈0.05）, whereas expression level of p21 was only associated with tumor invasion（P〈0.05）. Conclusion Taken together, the development and progression of gastric cancer relates to expressions of C-myc and p21, and C-myc might be considered as a biomarker for diagnosis of gastric carcinoma.