胃癌及癌前病变细胞的凋亡与增殖

目的 了解胃癌及癌前病变中细胞凋亡和增殖状态的变化，探讨其在胃癌发生中的作用。方法 采用脱氧核糖核酸转移酶介导的dUTP缺口末端标记（TUNEL）技术和增殖细胞核抗原（PCNA）免疫组织化学染色法观察58例胃癌、27例癌前病变和15例正常胃粘膜组织中细胞凋亡和增殖状态。结果 胃癌组织中细胞凋亡指数显著低于胃正常粘膜和胃癌前病变组织（2．8％，6．3％，12％，P＜0．05）；胃癌前病变细胞凋亡指数明显上升，显著高于正常胃粘膜（P＜0．05）；在正常胃粘膜、癌前病变及胃癌组织中凋亡／增殖比率呈递减趋势而细胞增殖指数则呈递增趋势（P＜0．05）；细胞凋亡指数与肿瘤组织类型、分化程度、浸润深度和转移状况无关（P＞0．05），细胞增殖指数与肿瘤浸润深度和转移状况无关（P＜0．05）。结论 细胞凋亡和增殖的失衡可能是胃粘膜组织恶性转化的重要因素之一。

Cell Apoptosis and Proliferation in Gastric Carcinoma and its Precancerous Lesion

Objective\ To clarify the effects of cell apoptosis and proliferation on the pathogenesis of gastric carcinoma.\ Methods\ Using TdT\|mediated dUTP nick end labelling(TUNEL) technique and immunohistochemical method, observed and calculated apoptotic cells and proliferating cells in 15 normal gastric mucosa, 27 gastric precancerous lesions and 58 gastric carcinoma specimens.\ Results\ The apoptotic index(AI) in gastric carcinomas was significantly lower than those in normal mucosa and gastric precancerous lesions(2 8%, 6 3% and 12%, respectively).\ The apoptotic index in gastric precancerous lesions was higher than that in normal mucosa.\ Comparison of normal mucosa with gastric precancerous lesions and gastric carcinoma, the ratio of apoptosis to that of proliferation was reduced(0 67, 0 25, 0 05, P<0 05) and proliferating index(PI) increased significantly(9 8%,48%,65%,P<0 05).\ The value of AI didn't relate to histological type, depth of tumor invasion, lymph nodes or distant metastasis. \ \{Conclusion\}\ Abnormality in cell apoptosis and proliferation may play an important role in the pathogenesis of gastric carcinoma.