Ki67和PCNA在胃癌中的表达及其临床诊断价值

目的 分析Ki67和PCNA在慢性胃炎组织、上皮内瘤变组织及癌组织中表达的差异,并评价其临床诊断价值.方法 用免疫组织化学方法检测所有标本Ki67及PCNA的表达,其中胃癌27例,慢性胃炎30例,低级别上皮内瘤变32例,高级别上皮内瘤变19例.结果 Ki67与PCNA在慢性胃炎组、低级别上皮内瘤变组、高级别上皮内瘤变组、胃癌组的阳性表达率呈明显递增关系.随着病变加重,强阳性表达显著增多,差异有显著性（P〈0.001）,随着病变加重,阳性表达范围逐渐增大.结论 Ki67和PCNA反映了胃七皮细胞在癌变过程中细胞增殖活性的改变.增殖活性的改变与癌变过程密切相关.检测Ki67和PCNA可作为预测癌变的观察指标.

The expressions and significance of clinical diagnosis of Ki67 and PCNA protein in gastric cancer

Objective To investigate the expressions of Ki67 and PCNA protein in chronic gastritis,intraepithelial neoplasia and carcinoma, analysis the different expression and evaluate significance of clinical diagnosis. Methods Immunohistochemistry was used to detect the expressions of Ki67 and PCNA in all specimens,which encluded 27 cases of gastric cancer,30 cases of chronic gastritis,32 cases of low- grade intraepithelial neoplasia and 19 cases of high-grade intraepithelial neoplasia. Results The expres-sion of Ki67 and PCNA in chronic gastritis, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia and gastric cancer were significantly increased （ 40% , 68.8% , 94.7% , 100% ） respectively. With the deterioration of the disease, strong expression was increased significantly（ P 〈 0. 001 ） and the positive range was increased gradually. Conclusions The expressions of Ki67and PCNA reflected the proliferation changes of gastric epithelial cells in the process of cancer ration. The change of proliferative activity was closely related with carcinogenesis. Detection of Ki67 ,PCNA could be used to predict cancer ration. Ki67and PCNA was used to determine cancer,which should not be confined to the positive rate and staining intensity,and should be studied further from the location and scope to develop a better criteria.