p53、bcl-2、c-erbB-2在胃癌及癌前病变中表达的意义

目的：研究p53、bcl-2、c-erbB-2基因在胃癌及癌前病变中的表达，探讨其与胃癌发生的关系。方法：采用免疫组化SABC法，检测p53、bcl-2、c-erbB-2基因蛋白在98例胃癌、39例肠上皮化生、40例不典型增生和20例正常胃粘膜中的表达。结果：①p53在胃癌中的阳性表达率为55．1％，早期胃癌和进展期胃癌分别为50．0％，55．4％；在肠上皮化生中的表达率为12．8％，与早期胃癌比较有统计学差异（P〈0．05），随不典型增生程度的加重p53的表达率逐渐升高，依次为5％，20％，60％，其中轻中度与重度不典型增生差异有统计学意义（P〈0．05），而在正常胃粘膜中未见p53表达②bcl-2在正常胃粘瞑中有弱阳性表达（10．0％），在不典型增生中为50．0％，在胃癌中为44．9％，不典型增生与胃癌中的表达均显著高于正常胃粘膜（P〈0．05）。③c-erbB-2在胃癌中的阳性表达率为55．1％，其中在早期胃癌中的表达率较低（16．7％），在重度不典型增生和进展期胃癌中的表达率较高，分别为60．0％和57．6％，二者与早期胃癌比较差异有统计学意义（P〈0．05）。④c-erbB-2表达与肿瘤浸润深度、淋巴结转移有关（P〈0．05），与胃癌分化程度无关（P〉0．05）；bcl-2表达与胃癌的分化程度有关（P〈0．05），低分化者bcl-2表达率高，与淋巴结转移，浸润深度无关（P〉0．05）；p53表达与上述临床病理因素均无关（P〉0．05）。结论：p53，bcl-2，c-erbB-2参与了胃粘膜的癌变过程。

The significance of the expression of p53,bcl-2 and c-erbB-2 genes in gastric cancer and its precancerous lesions

Objective:To explore the expression of p53,bcl 2,c erbB 2 genes in gastric cancer(GC)and precancerous lesions and define whether the expression of the genes were associated with the stomach carcinogenesis.Methods:immunohistochemical technique SABC method was used to detect the expression of p53,bcl 2,c erbB 2 in 98 cases of GC,39 cases of intestinal metaplasia,40 cases of dysplasia and 20 cases of normal gastric mucosa.Results:1.The expression of p53 gene was detected in GC(55.1%) and the early stage(50.%),the advanced stage (55.4%) of GC, it also was seen in intestinal metaplasia (12.8%), there was significant difference between the intestinal metaplasia and the early stage of GC(P<0.05).The positive rate of p53 expression was 5%,20%,60% in mild,moderate and severe epithelial dysplasia(P<0.05),respectively.The p53 expression was not found in normal stomach mucosa.2.The bcl 2 expression was weakly observed in 20 control subjects,but it was strong in gastric epithelial dysplasia(50%) and GC(44.9%),significant difference was seen between dysplasia and normal gastric mucosa,between GC and normal gastric mucosa(P<0.05).3.The expression of c erbB 2 gene was found in GC(56.1%) and low in the early stage (16.7%) of GC,but high in the advanced stage (58.6%) and the severe epithelial dysplasia(60%),there was a significant difference between the two groups and the early stage of GC(P<0.05). 4.The expression of c erbB 2 had something to do with lymph node metastasis,depth of invasion(P<0.05) and anything to do with differentiation(P>0.05);no correlation between bcl 2 expression and lymph node metastasis,depth of invasion (P>0.05) was observed. Bcl 2 expression was related with differentiation of GC(P<0.05);the p53 expression was not correlated with the clinical pathological factors(P>0.05).Conclusion: p53,bcl 2,c erbB 2 may be involved in the development of GC.