胃癌及胃癌前病变中APC、bcl-2和c-met基因的表达及意义

Expressions of APC,bcl-2 and c-met in gastric cancer and its precancerous lesion and their significances

目的:探讨APC、bcl-2和c-met基因在胃癌发生、发展中的作用以及在胃癌早期诊断中的意义。方法:应用免疫组化技术检测APC、bcl-2、c-met蛋白在30例胃癌、30例不典型增生、30例肠上皮化生(肠化)、10例胃腺瘤及20例正常胃黏膜组织中的表达。结果:①APC阳性表达率在肠化、不典型增生、胃癌及胃腺瘤组织中表达率分别为66.7%、53.3%、53.3%和50.0%,与正常胃黏膜组织(90.0%)比较明显降低(P<0.05),其中中重度不典型增生APC表达率(47.1%)低于轻度不典型增生(61.5%)(P<0.05)。APC在无淋巴结转移的胃癌组织中表达率高于有淋巴结转移的胃癌组织(P<0.05)。②bcl-2阳性表达率在胃癌(66.7%)、不典型增生(43.3%)、肠化(40.0%)胃黏膜组织中表达率均明显高于正常对照组(5.0%)和胃腺瘤组(10.0%)(P<0.05);轻度不典型增生组阳性表达率(30.8%)低于胃癌组(P<0.05);中重度不典型增生组(52.9%)与胃癌组比较差异无显著性(P>0.05)。中高分化胃癌组织中bcl-2表达率者高于低分化者(P<0.05),Lauren分型肠型胃癌中表达率高于弥漫型(P<0.05)。③c-met阳性表达率在胃癌(63.3%)、肠化(63.3%)和不典型增生组织(60.0%)均明显高于正常胃黏膜组(10.0%)和胃腺瘤组(10.0%)(P<0.05);中重度不典型增生组阳性表达率(70.6%)明显高于轻度不典型增生组(46.1%)(P<0.05);中重度肠化组阳性表达率(75.0%)明显高于轻度肠化组(55.6%)(P<0.05)。中高分化胃癌c-met阳性表达率高于低分化胃癌(P<0.05),有淋巴结转移者高于无淋巴结转移者(P<0.05)。结论:APC基因的失活、bcl-2和c-met基因的过表达对胃癌的发生、发展起促进作用;对中重度不典型增生胃黏膜进行APC、bcl-2和c-met基因检测有助于胃癌的早期诊断。

Objective To investigate the role of the expressions of APC, bcl-2 and c-met gene in the progress of gastric cancer and their significances in the diagnosis of early gastric cancer. Methods The immunohistochemical technique was used to detect the expressions of APC, bcl-2 and c-met gene in 30 cases of human gastric carcinoma （GC）, 30 cases of intestinal metaplasia （IM）, 30 dysplasia （Dys） gastric mucosa, 10 gastric adenoma （GA） and 20 normal gastric mucosa. Results ①The positive expression rates of APC in GC, IM, Dys and GA （53.3N, 67.7% and 53, 3%, respectively） were significantly lower than those in normal gastric mucosa （90.0%, P〈0.05）. The positive rate of APC in moderate and severe Dys （47. 1%） was lower than that in mild Dys （61.5%, P〈0.05）. The expression rate of APC in GC without lymph node metastasis was higher than those with lymph node metastasis （P〈0.05）.②The positive expression rates of bcl-2 in GC （66.7%）, IM （40. 0%） and Dys （43.3%） were higher than those in normal gastric mucosa （5. 0%） and GA （10. 0%） . The positive expression rate of bcl-2 in mild Dys （30.8%） was lower than those in GC （66. 7%, P〈0. 05）. The bcl-2 expression showed a significant negative correlation with lymph node metastasis and Lauren type （P 〈 0. 05） . ③The positive expression rates of c-met in GC （76.0%）, IM （63.3%） and Dys （60.0%） were higher than those in normal gastric mucosa （10.0%, P〈0. 05）） and gastric adenoma （10.0%, P〈0.05）. The positive expression rate of c-met in moderate and severe IM （70.6%） was higher than those in mild IM （46.1%, P〈0. 05）. The positive expression rate of c-met in moderate and severe Dys （75%） was higher than that in mild Dys （55.6%, P〈0.05）. The expression of c-met gene in GC with well differentiation was higher than that with bad differentiation （P〈 0.05）. The expression of c-met gene in GC with lymph node metastasis was higher than that without lymph node metastasis （P〈0. 05）. Conclusion The lose of APC or bcl-2 and c-met gene overexpression are contributed to the occurance and development of GC. To detect the expressions of APC, bcl-2 and c-met gene in moderate and severe Dys may be helpful for diagnosis of early gastric cancer.