胃黏膜病变组织中hTERT的表达及其与幽门螺杆菌感染的关系

目的探讨胃癌前病变组织及胃癌中人端粒酶逆转录酶（hTERT）的表达状况及其与幽门螺杆菌（Hp）感染的关系。方法应用免疫组织化学技术检测130例胃黏膜多阶段病变组织中hTERT的表达，用快速尿素酶法和Warthin—Starry银染色法检测Hp。结果hTERT阳性率及Hp感染率慢性浅表性胃炎为0％（0／25）、20．0％（5／25），萎缩性胃炎为15．6％（7／45）、44．4％（20／45），轻-中度异型增生为500％（6／12）、58．3％（7／12），重度异型增生为55．6％（5／9）、6617％（6／9），胃癌为692％（27／39）、74．4％（29／39）。被检标本hTERT阳性率及Hp感染率均随病变加重而增高（均P〈0．01）。Hp阳性患者hTERT阳性率为55.2％，Hp阴性患者hTERT阳性率为14．3％，两者之间的差异有统计学意义（P〈0．01）；不同肿瘤大小、浸润深度、临床分期及有无淋巴结转移，胃癌患者hTERT阳性率的差异均无统计学意义（均P〉0．05）。结论在胃癌和胃癌前病变阶段，Hp感染可能通过激活胃黏膜上皮细胞端粒酶，使hTERT高表达，胃黏膜上皮细胞增生，从而促进了胃癌的发生和发展。

Relationship between hTERT expression and Helicobacter pylori infection in human gastric diseases

Objective To investigate the relationship between hTERT expression and Helicobacter pylori （Hp） infection in human gastric diseases. Methods Gastric tissue samples were taken from 25 cases of chronic superficial gastritis, 45 chronic atrophic gastritis, 12 mild-moderate dysplasia, 9 severe dysplasia and 39 gastric carcinoma, hTERT expression was detected by immunohistochemical method in all 130 specimens and Hp was detected by rapid urease test and Warthin-Starry silver stain. Results The positive rate of hTERT protein and Hp infection were detected in 0% （0/25） and 20.0% （5/25） of chronic superficial gastritis, 15.6% （7/45） and 44.0% （20/45） of atrophic gastritis, 50.0% （6/12） and 58.3% （7/12） of mild-moderate dysplasia, 55.6% ,（5/9） and 66.7% （6/9） of severe dysplasia, 69.2% （27/39） and 74.4% （29/39） of gastric cancer, respectively. Both detection rates in hTERT protein and Hp infection increased with the pathological changes from normal to cancer. The positive rate of hTERT protein in patients with positive Hp infection （55.2%） was significant higher than that in patients without Hp infection （14.3%, P〈0.01）. The expression of hTERT in gastric cancer tissues was not related to tumor sizes, infiltrating depth, lymph node metastasis, histological grades and TNM stages. Conclusion The results suggest that Hp infection might play an important role in the carcinogenesis and progression of gastric carcinoma, which is associated with over-expression of hTERT and proliferation of gastric epithelial cells.