贲门癌及癌前病变中细胞凋亡与FasL表达的关系

Apoptosis and Its Relationship with Fas Ligand Expression in Cardia Carcinoma and Its Precancerous Lesion

目的研究贲门癌前病变及贲门癌中细胞凋亡与FasL表达的关系,探讨细胞凋亡在贲门癌发生中的作用。方法采用脱氧核糖核酸末端转移酶介导的dUTP缺口末端标记(TUNEL)技术及免疫组化染色对正常胃黏膜10例,慢性胃炎72例和贲门癌50例中凋亡细胞及FasL表达状态进行原位观察和比较。结果萎缩性胃炎、Ⅰ、Ⅱ、Ⅲ型肠化生及异型增生的凋亡细胞指数(12.8%,17.0%,14.6%,9.6%,8.0%)显著高于正常黏膜(3.4%)和癌(5.8%)(P<0.01及P<0.05);异型增生组织凋亡细胞指数(8.0%)显著低于萎缩性胃炎和Ⅰ型、Ⅱ型肠化生(12.8%,17.0%,14.6%;P<0.05及P<0.01);Ⅲ型肠化生的凋亡细胞指数(9.6%)显著低于Ⅰ型、Ⅱ型肠化生(17.0%,14.6%;P<0.01及P<0.05)。正常胃黏膜无FasL表达,贲门癌前病变及贲门癌中均有不同程度的FasL表达。FasL表达阳性肠化生、异型增生和贲门癌中的凋亡细胞指数(19.8%,10.0%,8.3%)显著高于其阴性组(12.6%,6.1%,3.4%;P<0.05及P<0.01)。结论FasL对贲门癌前病变及贲门癌组织细胞凋亡具有促进性调控作用,细胞凋亡调控异常在贲门癌发病中可能起重要作用。

Objective To investigate the effects of apoptosis and Fas ligand （FasL） in different stages of malignant transformation of cardia epithelium in precancerous lesions and cardia carcinomas. Methods Using terminal deoxynucleotidyl transferase -mediated nick end labelling （TUNEL） technique and immuno - histochemical staining, we observed the apoptotic cells and the FasL expression in situ in 10 cases of normal cardia mucosa, 72 chronic gastritis and 50 cardia careinoma. Results The apoptotic indexes in atrophic gastritis, type Ⅰ, Ⅱ and Ⅲ intestinal metaplasia and gastric dysplasia （ 12.8%, 17.0%, 14. 6% ,9.6% ,8.0% ） were significantly higher than that in normal mucosa （3.4%） and cardia carcinoma （5.8% ; P 〈0.01 and P 〈 0.05）. The apoptotic index in gastric dysplasia （8.0%） was significantly lower than that in atrophic gastritis and type Ⅰ,Ⅱ intestinal metaplasia （ 12.8%, 17.0%, 14.6% ; P 〈 0.05 and P 〈 0.01 ）and the apoptotic index in type Ⅲ intestinal metaplasia（9.6% ） was significantly lower than that in types Ⅰ and Ⅱ （ 17.0%, 14.6% ; P 〈 0.01 and P 〈 0.05）. FasL was differently expressed in cardia carcinomas and precancerous lesions, in intestinal metaplasia, gastric dysplasia and, cardia carcinoma, the apoptotic index in the FasL positive group （19.8% ,10.0% ,8.3% ）was higher than that in the FasL negative group （12.6% ,6. 1% ,3.4% ; P 〈0.05 and P 〈0.01 ）. Conclusion The abnormal regulation of apoptosis may play an important role in the pathogenesis of cardia carcinoma. The FasL can promote apoptosis in cardia carcinoma and its precancerous lesions.