胃癌发生过程中凋亡基因Survivin与Fas表达及其与幽门螺杆菌感染的关系

目的探讨凋亡基因Survivin、Fas在胃癌发生过程中的表达、临床意义及和幽门螺杆菌（Hp）感染的关系。方法采用分子原位杂交分别检测12例正常胃黏膜、22例浅表性胃炎、25例肠上皮化生、37例异型增生及52例胃癌组织中的Survivin-mRNA和Fas-mRNA表达，并检测患者Hp感染状况。结果Survivin-mRNA在肠上皮化生、异型增生组和胃癌组织中的阳性率分别为28．0％、43．2％和69．2％。胃癌组明显高于肠化和异型增生组（P〈0．01；P〈0．05）。胃癌组Fas-mRNA阳性率为36．5％，显著低于对照组和异型增生组（P均〈0．01）。Survivin-mRNA在高分化、中分化和低分化及未分化型胃癌组织中阳性率呈现递增趋势，而且其表达和淋巴结转移、远处转移密切相关。Fas-mRNA阳性率在高、中和低分化及未分化型胃癌患者中呈现递减趋势，且其表达和淋巴结转移密切相关。异型增生患者Survivin-mRNA表达与Hp感染之间呈明显正相关（P〈0．01）。相关回归分析显示胃癌患者各病理分期中Survivin-mRNA与Fas-mRNA表达呈负相关。结论在胃黏膜癌变过程中，Survivin的表达和作用逐渐上调，而Fas的表达和作用逐渐下调，而且在癌前病变组织中Survivin表达和Hp感染有密切关系；在胃癌组织中Survivin和Fas的表达呈负相关。

Expression and significance of survivin and Fas in carcinogenesis of gastric mucosa and its relationship with H. Pylori infection

Objective To investigate the expressions and the clinical significance of Survivin and Fas in human carcinogenesis of gastric mucosa and its relationship with Helicobacter pylori(Hp)infection. Methods The expressions of Survivin-mRNA and Fas-mRNA were detected by in situ hybridization in hu- man tissues,including 12 cases of normal gastric mucosa,22 cases of intestinal metaplasia,37 cases of a- typical hyperplasia and 52 cases of gastric carcinoma.H.pylori infection was evaluated by Rapid Urease Test and Hp special histological staining.Results The positive rates of Surviving-mRNA in patients with intesti- nal metaplasia,atypical hyperplasia and gastric cancer were 28.0%,43.2% and 69.2% respectively.The positive rate of Surviving-mRNA in gastric cancer tissue is negatively parallel with the increase of differentia- tion grade.Survivin-mRNA expression in gastric cancer tissues were significantly higher than that in patients with intestinal metaplasia and atypical hyperplasia(P<0.01 and P<0.05).The positive rate of Fas-mRNA in gastric cancer tissue is parallel with the decreasing in grade of differentiation.Fas-mRNA expression in gastric cancer tissues(36.5%)were significantly lower than those in the normal controls and patients with atypical hyperplasia(P<0.01,for all).Survivin-mRNA expression is correlated with lymph node metasta- sis and remote metastasis(P<0.05).There was a positive relation between the expression of Survivin-mR- NA and Hp infection rates in patients with atypical hyperplasia(P<0.01).Significantly negative relation- ship was found between the expression of Survivin-mRNA and Fas-mRNA in patients with gastric carcinoma. Conclusion The expression of Survivin was gradually up-regulated and conversely the expression of Fas was progressively down-regulated during the course of gastric cancer progression.There was a correlation between the expression of Survivin-mRNA and Hp infection positive rates in precancerous lesions.A negative relation was found between the expression of Survivin-mRNA and Fas-mRNA in gastric carcinoma.