胃癌及癌前病变组织中幽门螺杆菌感染与p53、p21WAF1、PCNA、cyclinA蛋白表达的相关性研究

Relationship between HP Infection and Expression of p53、p21WAF1、PCNA、cyclinA in Gastric Carcinoma and Precarcinoma Lesion

目的探讨胃癌及癌前病变中p53、p21WAF1、PCNA、CyclinA蛋白的表达及其与幽门螺杆菌感染的关系。方法应用免疫组化SP法染色及Warthin-Starry银染色、PCR、尿素酶法检测胃癌及有关病变中p53、p21WAF1、PCNA、CyclinA蛋白的表达和幽门螺杆菌感染情况。结果在慢性浅表性胃炎(CSG)、慢性萎缩性胃炎、(CAG)、肠上皮化生(IM)、不典型增生(Dys)及胃癌(GC)中,p53阳性表达率随病变发展而逐渐升高,p53阳性表达率分别为0、3.3%、6.7%、25.0%、70.6%。p21WAF1阳性表达率随病变发展而降低,p21WAF1阳性表达率分别为100.0%、96.7%、86.7%、75.0%、42.6%。PCNA和cyclinA阳性表达率随病变发展而升高,PCNA阳性表达率分别为45.0%、60.0%、70.0%、87.5%、85.3%;CyclinA阳性表达率分别为0、6.7%、20.0%、47.5%、58.8%。在同一病变中HP阳性组p53、p21WAF1、PCNA、cyclinA阳性表达率高于HP阴性组,GC组有显著差异(P<0.05)。就1种基因的表达而言,HP阳性组各类病变之和与阴性组比较均有显著性差异(P<0.05)。胃癌中p21WAF1与p53蛋白表达呈负相关关系(P<0.01,γ=-0.598),PCNA与cyclinA蛋白表达呈正相关关系(P<0.01,γ=0.956)。结论p53突变及p21WAF1失活和PC-NA、cyclinA蛋白的高表达及HP感染共同参与胃癌的发生、发展。

Objective To study the relationship between HP infection and expression of p53 ,p21WAF1 ,PCNA,cyclinA in gastric carcinoma and precarcinoma lesion. Methods The S-P immunohistochemical staining and Warthin-Starry staining, PCR,Urease test. Results For chronic superficial gastritis（CSG） ,chronic atrophic gastritis（CAG） ,intestinal metaplasia （IM）, dysplasia （Dys）, gastric carcinoma （ GC ）, the positive expression rates of p53 were 0,3.3% ,6.7% ,25.0% ,70.6% respectively （increased with pathological process） ; the positive expression rates of p21WAF1 were 100.0% ,96.7% ,86.7% ,75.0%, 42.6% respectively（ decreased with pathological process） ; the positive expression rates of PCNA were 45.0% ,60.0% ,70.0%, 87.5% ,85.3. % respectively; the positive expression rates of cyclinA were 0,6.7% ,20.0% ,47.5% ,58.8% respectively. In the same pathological changes, the positive expression rates of p53 ,p21WAF1 ,PCNA ,cyclinA was higher in HP infection group than in HP negative group, while there was significant difference in GC group （ P 〈 0.05 ）. As far as a gene expression is concerned, there are significant differences between HP positive groups and HP negative groups in the different pathological changes. There was a negative correlation between p21WAF1 and p53 protein expression （P 〈 0.01, γ = - 0. 598 ）. PCNA expression was positively correlated with cyclinA （P 〈 0.01, γ = 0. 956）. Conclusion The mutation of p53 and inactivation of p21WAF1 and the overexpression of PCNA ,cyclinA and HP infection play an important role in the occurrence and development of gastric carcinoma.