胃癌患者幽门螺杆菌感染和Smad4表达及其临床病理学意义的研究

目的 检测幽门螺杆菌(Hp)阳性和阴性胃癌患者的病变组织中Smad4的表达分布,并分析其与胃癌患者临床病理学特征之间的关系.方法 选取39例胃癌患者的胃镜活检组织标本,采用快速尿素酶试验(RUT)结合Giemsa染色判断Hp感染,采用冰冻切片免疫组化染色方法在蛋白水平检测Smad4的表达分布.结果 胃癌组织中Hp阳性者Smad4表达(42.9%)显著低于其阴性者(90.9%,P<0.05),胃癌患者Hp的感染与Smad4的表达呈负相关(r=-0.436,P<0.05).Smad4在胃癌组织中的表达(56.4%)显著低于其在正常胃黏膜中的表达(100%,P<0.05).Smad4的表达与胃癌的浸润及细胞分化程度相关,浸润程度越重、分化程度越低,其阳性表达率亦越低(P<0.05);而Smad4蛋白的表达与性别、年龄、TNM分期、淋巴结及远处转移无关.结论 胃癌患者中Hp感染与Smad4的表达有相关性,Smad4在胃癌发生、发展中发挥着重要作用,可能作为胃癌诊断和预后的分子标志,Hp可能通过Smad4而在胃癌的发生发展中起到重要作用.

Study of helicobacter pylori infection and expression of Smad4 in gastric carcinoma tissue and the clinical pathological characteristics

Objective To detect the expression and disposition of Smad4 in the gastric carcinoma tissue with helicobacter pylori(Hp)infection and in the gastric carcinoma tissue without Hp infection,and to analyze the relationship between the expression of smad4 and the clinical pathological characteristics.Methods The 39 cases of gastric carcinoma were obtained from gastroscopy and whether or not Hp infected was determined by rapid urease test(RUT)combined with Giemsa staining,and compared in the level of protein by means of frozen section method for immunohistochemical staining.Results The positive rate of Smad4 expression(42.9%)had a significant decrease in the Hp-positive gastric carcinoma patients,compared with the Hp-negative patients(90.9%,P<0.05).The infection of Hp had negative correlation with the positive expression of smad4(r=-0.436,P<0.05).The positive rate of Smad4 expression in the gastric carcinoma tissue(56.4%)was significantly lower than that in the normal gastric mucosal tissue(100%,P<0.05).Smad4 expression was associated with the depth of infiltration and the degree of differentiation,while the Smad4 expression did not have association with the sex,age,TNM staging,lymph node metastasis and distant metastasis.Conclusions There is a closed correlation between the expression of Smad4 and the Hp infection in gastric carcinoma tissue.The Smad4 plays an important role in the occurrence and development of gastric carcinoma.It can be a molecular marker in the diagnosis and prognosis of the gastric carcinoma.Hp maybe play an important role in the development of gastric carcinoma through Smad4.