残胃黏膜中白细胞介素-8环氧化酶-2和三叶肽因子1mRNA的表达及意义

Expression and significance of interleukin-8 cyclooxygenase-2 and trefoil family factor 1 in the remnant stomach mucosa

目的分析和探讨残胃黏膜中白细胞介素-8(IL-8)、环氧化酶-2(COX-2)和三叶肽因子1(TFF1)mRNA的表达特点及其与残胃内癌发生的相关性。方法收集残胃病例58例,均行胃镜检查,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)的感染检测,并通过实时PCR方法检测IL-8、COX-2和TFF1的mRNA表达。结果在吻合口处,Hp感染阳性的残胃黏膜COX-2mRNA的表达,明显高于Hp感染阴性者(P<0.05);而IL-8mRNA的表达,两者差异无统计学意义。在残胃体部,Hp感染阳性的残胃黏膜IL-8和COX-2mRNA的表达,明显高于Hp感染阴性者(P<0.05)。Hp感染阴性时,在吻合口处,行BⅠ式吻合的残胃黏膜中,IL-8和COX-2mRNA的表达明显高于行BⅡ式吻合者(P<0.05);在残胃体部,行BⅠ式吻合的残胃黏膜中,COX-2mRNA的表达明显高于行BⅡ式吻合者(P<0.05),而IL-8mRNA的表达,两种术式差异无统计学意义。在吻合口处和残胃体部,Hp感染阳性的残胃黏膜TFF1mRNA的表达,与Hp感染阴性者相比,差异均无统计学意义。结论Hp感染和胆汁反流是残胃癌发生的重要危险因素;IL-8和COX-2的表达与残胃癌发生的危险性有关;残胃黏膜中TFF1的表达与残胃癌发生的关系需进一步探讨。

Objective To study the expression and significance of interleukin-8 （IL-8）, cyclooxygenase - 2 （ COX - 2 ） and trefoil family factor 1 （ TFF 1 ） in the remnant stomach mucosa. Methods Patients after gastrectomy were examined by upper gastrointestinal endoscopy. Biopsy specimens were obtained from stoma and the greater curvature of the upper corpus to be assessed for Hp （ by H.E. and Giemsa staining） and conduct real-time semi-quantitative PCR. mRNA was extracted from the biopsy specimens to determine the IL - 8 , COX - 2 and TFF 1 gene mRNA levels by real - time PCR method. Results In the stoma, COX-2 level in Hp-positive patients was significantly higher than that in Hp-negative patients, but the difference of IL-8 levels between them was not significant. In the corpus, IL-8 and COX-2 levels in Hp-positive patients were significantly higher than those in Hp-negative patients. In Hp-negative patients, IL-8 and COX-2 levels in the stoma were significantly higher in BⅡ anastomosis than in BⅠ anastomosis cases; COX-2 level in the stoma was significantly higher in BⅡ anastomosis than in BⅠ anastomosis cases, but the difference of IL-8 levels between them was not significant. TFF1 level in the remnant stomach mucosa showed no significant difference between Hp-pesitive and Hp-negative patients. Conclusion Hp infection and bile reflux are important risk factors for the secondary stomach carcinogenesis. Expression of IL-8 and COX-2 in the remnant stomach mucosa is related to the risk of secondary stomach carcinogenesis. The relationship between the TFF1 expression and secondary stomach carcinogenesis in the remnant stomach mucosa is still unclear and should further be studied.