胃癌中幽门螺杆菌感染与胃粘膜增殖及凋亡研究

目的研究幽门螺杆菌(Hp)感染的胃癌(GC)发展中增殖细胞核抗原(PCNA)表达及细胞凋亡的关系和对胃癌预后意义。方法145例经病理证实,不同胃黏膜病变采用免疫组化检测PCNA基因表达及Warthinstarry法检测Hp感染。采用原位末端标记法(TUNEL)检测细胞凋亡。结果在浅表性胃炎(CSG)、萎缩肠化生胃炎(CAG+IM)、异型增生(DYS)、早期GC和进展期GC中,PCNA基因表达率分别为24.53%,46.28%,60.54%,57.67%和71.42%,CAG+IM、DYS、GC均显著高于CSG(P<0.05)。凋亡指数(AI)分别为(4.55±2.33)%、(6.43±5.60)%、(6.45±5.12)%、(6.55±4.80)%、(8.84±5.63)%,进展期GC显著高于CSG(P<0.05)。胃黏膜凋亡指数与PCNA表达强度有密切相关(P<0.05)。PCNA阳性表达与胃癌组织类型、浆膜浸润和淋巴结转移密切相关,而且BorrmannIV明显高于早期胃癌和BorrmannI,II(P<0.05)。PCNA阳性表达与肠型胃癌Hp感染有关。CAG+IM,DYS和GC组PCNA阳性表达中Hp感染者明显高于阴性者。Hp阳性者5年生存期显著短于Hp阴性者。结论Hp感染和PCNA表达与胃黏膜增殖和恶化有关,且与凋亡有相关性。Hp感染与胃癌预后有关。

Relationship of Helicobacter pylori infection to the expression of proliferating cell nuclear antigen and apoptosis in gastric carcinoma

To determine whether there exist any relationship between Helicobacter pylori (Hp)infection and the expression on proliferating cell nuclear antigen (PCNA) and apoptosis in gastric carcinoma (GC),145 samples of gastric mucosal lesions identified by pathological examinations were tested by using the immunohistochemical testings, the infections with Hp were examined by Warthin-starry method and the TUNEL method was used to detect the occurrence of apoptosis. It was found that the expression percentages of PCNA in chronic superficial gastritis (CSG), chronic atrophic gastritis plus intestinal mataplasia (CAG+IM), dysplasia (DYS),early GC and advanced GC were 25.53%, 51.28%, 61.54%, 66.67% and 68.42% respectively, with a higher positive rates in CAG+IM, DYS and GC. Meanwhile, the apoptotic indexes (AI) in the corresponding groups were 4.55±2.33 %, 6.43±5.60%, 6.45±5.12%, 6.55±4.80%, 8.84±5.63% with a higher rate in advanced GC. As demonstrated in the rank correlation test, the expression of PCNA increased with apoptotic indexes, showing a close relationship. In addition, the expression of PCNA was correlated significantly with histologic types, serosal invasion and lymph node metastasis, that is, its expression was rather higher in Borrmann type IV GC than in early GC or Borrmann type I and II, it also was higher in cases with GC infected with Hp than those cases not infected with Hp, and the survival rates of patients with Hp infection was significantly shorter than those of patients without Hp infection. It is concluded that Hp infection and PCNA expression may be associated with apoptosis and the malignant transformation of gastric carcinoma.