胃粘膜异型增生C-erbB-2基因表达及其癌变率的研究

目的　利用免疫组化的方法探索癌前病变到癌这一过程的转化 ,探索C erbB 2基因在这一转化过程的重要作用以及在胃癌早期诊断中的意义。方法　采用胃镜活检标本 ,选择胃粘膜异型增生的病例 ,资料完整 ,有随访结果 ,分出癌变组与未癌变组 ,利用免疫组化的方法检测C erbB 2基因蛋白表达情况。结果　正常胃粘膜、轻、中、重度异型增生的癌变率分别为 0、3 4%、10 7%、16 7%,随着异型增生的程度增加其癌变率增加。未癌变组C erbB 2蛋白表达的阳性率分别为 0、5 6 1%、72 %、83 3%,癌变组分别 0、5 0 %、33 3%、2 0 %,中、重度异型增生未癌变与癌变组间差异有显著性 (P <0 0 5 )。在癌变组C erbB 2蛋白表达的阳性率降低 ,而癌变率增加。结论　异型增生是一种重要的癌前病变 ,C erbB 2基因的变异在胃癌的发生、发展中起重要作用 ,对异型增生胃粘膜进行C erbB 2基因检测有助于胃癌的早期诊断和治疗。

Investigation of the expression of C-erbB-2 gene in gastric mucosal dysplasia and the rates of canceration

Aim To investigate the progress of carcinogenesis of stomach and the significance of C-erbB-2 gene in the diagnosis of early gastric cancer.Methods The expression of C-erbB-2 protein in gastric mucosa of each phase from normal ones to gastric mucosal dysplasia were detected by immunohistochemical staining.Results The rates of canceration from normal ones to mild,moderate and severe dysplasia were 0,56.1%,72% and 83.3% respectively.The higher the dysplasia grade was,the higher rates of canceration would be.Relatively high positive rates of the expression of C-erbB-2 protein were found in mild,moderate and severe dysplasia (50%,83.3% and 85.7% respectively) in the non-cancer group,the rates were 50%,33.3% and 20% respectively in the cancer group.There was significant difference between non-cancer group and cancer group in moderate,severe dysplasia(P<0.05).In the cancer group,the higher the dysplasia grade was,the lower positive rate of the expression of C-erbB-2 protein was,but the rate of canceration was higher.Conclusions Dyspalsia plays an important role in the course of gastric cancer.The variation of C-erbB-2 gene plays an important role in the progress of carcinogenesis of stomach.Detecting of the C-erbB-2 gene in dysplasia could predict the canceration trend and contribute to the diagnosis of early gastric cancer.