幽门螺旋杆菌感染和FasL蛋白表达在胃癌发生中的变化

目的 探讨幽门螺旋杆菌(H.pylori)感染和Fas配体(FasL)蛋白表达在胃癌(GC)发生发展中的变化.方法 选取2010年1月至2011年9月在上海浦东新区南汇中心医院诊断的胃部病变169例患者,其中慢性浅表性胃炎(CSG)25例、慢性萎缩性胃炎(CAG)28例、肠化生(IM)37例、异型增生(Dy)38例和胃癌(GC)41例.分别检测胃黏膜组织中H.pylori感染和FasL的蛋白表达,分析H.pylori感染和FasL的蛋白在GC发生发展中的相关性.结果 H.pylori感染率和FasL蛋白阳性表达率随着病情的加重而逐渐增高,Dy组及GC组H.pylori感染率比CSG组明显升高(65.8％和75.6％ vs 16.0％)(P＜0.05);IM组、Dy组及GC组FasL蛋白阳性表达率比CSG组明显升高(64.9％、78.9％和92.7％ vs 28.0％)(P＜0.05) ;GC组FasL蛋白阳性表达率比CAG组及IM组明显升高(92.7％vs 60.7％；92.7％ vs 64.9％)(P＜0.05).除CSG外,H.pylori感染与CAG、IM、Dy和GC胃黏膜组织中的FasL蛋白表达具有一致性,差异有统计学意义(P＜0.01).结论 FasL蛋白表达和H.pylori感染对评估胃黏膜癌前病变发展趋势有重要的临床价值,有助于早期发现和诊断GC.

Changes of Helicobacter pylori infection and FasL expression in genesis of gastric cancer

Objective To evaluate the changes of Helicobacter pylori（H, pylori ） infection and Fas ligand（FasL） expression in the genesis of gastric cancer. Methods 169 cases of gastric lesions diagnosed patients from January 2010 to September 2011 in Nanhui Central Hospital, Shanghai, including chronic superficial gastritis （CSG） （25 cases）, chronic atrophic gastritis（CAG） （28 cases） ,intestinal metaplasia（IM） （37 cases） ,dysplasia（Dy） （38 cases） and gastriccancer（GC） （41 cases）,were detected for H. pylori infection and the protein expression of FasL in gastric mucosa,and the correlation of H. pylori infection and FasL protein in gastric mucosa were analyzed. Results The rates of H. pylori infection and protein expression of FasL rates increased gradually with the aggravation of pathogenetic condition. The rates of H. pylori infection in Dy and GC were significantly higher compared with that of CSG（65.8% and 75.6% vs 16.0%, P 〈0.05）;The protein expression of FasL rates in IM,Dy and GC were significantly higher compared with that of CSG（64.90//00 and 78.9% and 92.7% vs 28.0%, P 〈0.05）;The protein expression of FasL rates in GC was significantly higher than that in CAG and IM （92.7% vs 60.7 and 64.9%, P 〈0.05）. Except CSG, the H. pylori infection of the gastric mucosa with CAG, IM, Dy and GC was consistent to the protein expression of FasL, the differences were statistically significant （Kappa= 0.515,0.419,0. 420 and 0. 393, all P 〈 0.01 ）. Conclusion There is important significance in clinical value to assess trends in gastric precancerous lesions with the protein expression of FasL and H. pylori infection,to help to detect the occurrence of early zastric cancer.