胃癌及癌前病变c-erbB-2、p53和ki-67表达及意义

目的探讨c-erbB-2、p53和ki-67基因蛋白在胃癌及癌前病变中的表达和意义。方法采用免疫组织化学染色对96例胃癌组织标本、10例正常胃粘膜、22例萎缩性胃炎、6例慢性胃溃疡伴肠上皮化生标本进行基因蛋白表达。结果自萎缩性胃炎、肠上皮化生、胃粘膜异型增生到不同病理类型的胃癌,c-erbB-2、p53和ki-67基因表达不同。在整个胃癌的演变过程中,基因表达是逐渐增强的。在不同阶段,基因表达高低也不一样,c-erbB-2在异型增生和胃癌表达最强,高于萎缩性胃炎和肠上皮化生,两者之间有显著性差异(P<0.05)。p53在低分化腺癌和高分化腺癌表达率分别是69.2%和32.3%,有显著差异(P<0.05)。ki-67在整个胃癌演变过程中的表达是逐渐增强的,而且在未分化癌中的表达高于c-erbB-2和p53。结论癌前病变和不同病理类型的胃癌c-erbB-2、p53和ki-67基因蛋白表达不同。说明胃癌的发生发展是多基因、多分子水平变化的多个阶段进行性过程。多项基因蛋白检测对胃癌的早期诊断及预后的判断更有意义。

Expressions of c-erbB-2, p53 and ki-67 in gastric carcinoma and precancerous lesions

Objective To investigate the expression and the significance of c-erbB-2, p53 and ki-67 in the gastric carcinoma and precancerous lesions.Methods Immunohistochemical staining (SP method) was used to detect the expression of c-cerbB-2, p53 and ki-67 in tissue samples of 96 cases of gastric carcinoma, 10 normal gastric mucosa, 22 chronic atrophic gastritis and 6 gastric peptic ulcer with intestinal metaplasia.Results The expressions of c-erbB-2, p53 and ki-67 were different in different samples, and were strengthened gradually according to the development of gastric carcinoma. c-erbB-2 expressed stronger in displasia and gastric carcinoma samples than in chronic atrophic gastritis and intestinal metaplasia samples; the difference is significant (P<0.05). The rate of expression of p53 in well-and poor-differentiated carcinomas is 69.2% and 32.3% respectively in gastric carcinoma and the expression of ki-67 is stronger than that of c-erbB-2, p53 in under-differentiated gastric carcinoma. Conclusion c-erbB-2, p53 and ki-67 express differently in different types of precancerous and gastric carcinoma tissue samples. It is suggested that the genesis of gastric carcinoma is developed in multiple-gene and multiple-molecule mechanisms and in different stages. The detection of multiple genes is useful for the diagnosis and prognosis of gastric carcinoma.