胃黏膜癌前病变中p53、p21^ras蛋白表达与幽门螺杆菌感染的关系

目的观察幽门螺杆菌(Helicobacterpylori)感染及根除H.pylori二年后p53、p21ras在二组胃黏膜上皮细胞的表达,探讨H.pylori在胃癌发生、发展中的作用.方法应用免疫组织化学染色、尿素酶快速试验(RUT)、组织学Warthin-Starry染色.198例H.pylori感染患者,慢性胃炎86例,慢性胃炎伴肠化生67例,慢性胃炎伴异型增生45例;对照组为根除H.pylori 2年后共86例,其中慢性胃炎54例,慢性胃炎伴肠化生32例,慢性胃炎伴异型增生10例.全部病例做p53、p21ras免疫组织化学染色.结果 H.pylori感染组p53、p21 ras 阳性表达率15.7%、18.7%,明显高于H.pylori根除组2.3%、7%,差异显著(P＜0.05);慢性胃炎伴肠化病变中,p53、p21ras在H.pylori感染组阳性表达率17.9%、18.4%均高于H.pylori根除组0%、9.4%,差异显著(P＜0.05)慢性胃炎伴异型增生病变中,p53、p21 ras在H.pylori感染组阳性表达率31.1%、40%均高于H.pylori根除组20%、30.4%,差异显著(P＜0.05);H.pylori 感染组p53、p21ras在慢性胃炎,肠化生,异型增生表达水平依次增高p53、p21ras共同表达阳性37例.结论在胃黏膜癌前病变中p53、p21ras 在H.pylori感染组阳性表达率高于H.pylori根除组,差异显著(P＜0.05);在慢性胃炎,肠化生,异型增生p53、p21ras表达水平在增高;p53、p21 ras表达呈正相关;H.pylori感染在胃癌发生、发展过程中起一定作用,p53、p21ras表达可能是H.pylori致癌的作用机理之一.

Relationship between Helicobacter pylori infection and expression of p53, p21ras protein in gastric precancerous lesions

Objective To determine the relationship between the infection of Helicobacter pylori ( H. pylori) and his togenesis of gastric carcinoma. Methods Among the 198 patients (test group) , etighty-six cases were diagnosed as chronic gastritis, sixty-seven casesas chronic gastritis with intestinal metaplasia, 45 cases as chronic gastritis with gastric epithelium dysplasia. In H. pylori was eradicated for 2 year (coutrol group) , 54 cases as chronic gastritis ,32 cases as chronic gastritis with intestinal metaplasia, 10 cases as chronic gastritis with epithelium dysplasia.p53 , p21ras protein were examined by immunohis-tochemical method, and H. pylori was detected by Warthi-Starry and RUT. Results The test group had higher rates of p53 , p21ras protein expression (15.7%, 18.7% respectively) than that in control group for 2 years (2.3% ,7% respectively, P < 0.05) , the patients with H. pylori infection had higher rates of p53, p21ras proteine xpression (17.9%, 28.4%) than that in H. pylori had been eradicated for 2 years (0%,9.4%, P<0.05)in with intestinal metaplasia, and the patients with H, pylori infection had higher rates of p53, p21ras protein expression(31 .1 % , 40% )than that in H. pylori have been eradicated for 2 years (20% , 30.4% , P < 0.05) in chronic gastritis with gastric epithelium dysplasia. The rate of p53, p21ras protein expression of chronic gastritis, chronic gastritis with intestinal metaplasia and gastric epithelium dysplasia was increasing in H. pylori infection group. Coexpression of p53, p21ras was 37 cases. Conclusions In gastric precancerous lesions, the patients with H. pylori infection have higher rates of p53, p21ras protein expression than that in H. pylori have been eradicated for 2 years ( P < 0.05) . In the test group, the rate of p53, p21ras protein expression of chronic gastritis,chronic gastritis with intestinal metaplasia and chronic gastritis with gastric epithelium dysplasia are increasing. H. pylori may act as a tumor promoter in the histogenesis of gastric carcinoma.