残胃黏膜白细胞介素-8和环氧化酶-2mRNA表达与吻合方式的关系

The relationship between the expressions of interleukin-8 and cyclooxygenase-2 and the type of anastomosis in the remnant stomach

目的 探讨残胃黏膜白细胞介素 8(IL 8)和环氧化酶 2(COX 2)mRNA表达的特点及其与吻合方式的关系。方法 选择 58例残胃病例行胃镜检查,于吻合口和胃体大弯处采用两点取材的方法进行胃镜活检,活检标本分别进行幽门螺旋杆菌 (Hp)感染检测和通过实时聚合酶链反应(PCR)方法检测IL- 8和COX 2mRNA表达。结果 吻合口处IL -8和COX -2mRNA表达与残胃体部的比较均有增高趋势,BillrothⅠ(BⅠ )式吻合口处的IL -8mRNA表达明显高于残胃体部的表达;当Hp感染阴性时,BⅠ式吻合口处IL- 8和COX -2mRNA表达明显高于BⅡ式吻合口处它们的表达;而当Hp感染阳性时,吻合口处BⅠ式的IL- 8和COX -2mRNA表达与BⅡ式的表达无显著差异;在残胃体部,不管BⅠ式还是BⅡ式吻合,Hp感染阳性的IL -8和COX -2mRNA表达明显高于Hp感染阴性的表达。结论 残胃吻合口周围癌发生的危险性高于其它部位;吻合方式影响残胃癌发生危险性。

Objective To study the expressions and the significance of interleukin-8 (IL-8) and cyclooxygenase-2 (COX-2) in the remnant stomach. Methods Fifty-eight patients with gastrectomy were examined by upper gastrointestinal endoscopy. Two biopsy specimens were obtained from the stoma and the upper corpus gastric mucosa in the remnant stomach. mRNA was extracted from biopsy specimens to measure the IL-8 and COX-2 gene mRNA levels by real-time PCR method. Results IL-8 and COX-2 levels were higher in stoma than in corpus, IL-8 levels in BⅠ anastomosis were significantly higher in stoma than in corpus( P<0.05). In Hp-negative patients, IL-8 and COX-2 levels in stoma were significantly higher in BⅡ anastomosis than in BⅠ anastomosis(P<0.05).In Hp-positive patients, IL-8 and COX-2 levels in stoma showed no significant differences between BⅡ anastomosis and BⅠ anastomosis. In corpus, IL-8 and COX-2 levels in Hp-positive patients were significantly higher than those in Hp-negative patients, (P<0.05), including in BⅠ anastomosis and in BⅡ anastomosis. Conclusions The risk of the secondary stomach carcinogenesis in stoma after distal gastrectomy is higher than that in corpus; The types of anastomosis may influence the risk for the secondary stomach carcinogenesis in the remnant stomach mucosa.