联合应用MG_7－Ag和AgNOR检测胃癌及萎缩性胃炎的研究

A STUDY ON GASTRIC CARCINOMA AND ATROPHIC GASTRITIS DETECTED WITH COMBINING MG7-Ag WITH AgNOR

用ＭＧ_７－Ａｇ和ＡｇＮＯＲ法对３０例胃癌、６４例慢性萎缩性胃炎（ＣＡＧ）、２０例正常胃粘膜研究。发现胃癌ＭＧ_７－Ａｇ强阳性高于ＣＡＧ（Ｐ＜０．００５）；中、重度ＣＡＧ或伴ＩＭ者高于轻度或局限胃窦ＣＡＧ（Ｐ＜０．０５）。以细胞核内ＡｇＮＯＲ计数明显增多（＞９．２６）或大小不等，呈团块状分布为阳性指标，则胃癌检出率高于ＣＡＧ（Ｐ＜０．００５），中、重度ＣＡＧ高于轻度（Ｐ＜０．０５）。ＭＧ_７－Ａｇ和ＡｇＮＯＲ联用，胃癌检出率可达９０％，高于单用任何一项者（Ｐ＜０．０２５），而假阳性检出与单项应用比Ｐ＞０．１。可为临床区分良恶性胃病提供有力的客观证据。

With combination of MG7-Ag and AgNOR, we studied 30 cases of gastric cancer, 64cases of CAG and 20 cases with normal gastric mucosa. We found that the rate of strongly positive expression of MG7-Ag in gastric cancer group was 53.3%,and significantly higher than that in CAG group(P<0.005). In CAG with extensive,moderate and severe atrophy or wth intestinal metaplasia (IM), the positive expression rate was higher than that in CAG with only mild and limited antral atrophy(P<0.05).Taking marked increase in AgNOR granule counting(>9.26), variation in granule size and uneven distribution with lump formation as positive criteria, the positive rate of AgNOR in gastric cancer group was higher than that in CAG group(P<0.005).The positive rate was higher in CAG with moderate or severe lesion than in CAG with mild lesion(P<0.05).The detection rate of gastric cancer using these two parameters was 90%.Therefore,the combined use of these two methods may be of high value in discriminating benign gastric disease from malignant one.