CDX2和PTEN蛋白表达与胃黏膜肠上皮化生关系的临床研究

Relationship of expression of CDX2 and PTEN proteins and gastric metaplasia

目的:探讨CDX2和PTEN蛋白表达与胃黏膜肠上皮化生(简称肠化)的关系。方法:观察肠化的胃黏膜病理形态特点,应用免疫组织化学法检测23例单纯肠化、33例不典型肠化和44例胃癌中CDX2、PTEN蛋白的表达,分析其与单纯肠化、不典型肠化及胃癌的关系。结果:CDX2蛋白在单纯肠化、不典型肠化及胃癌中的阳性率分别为82.6%、51.5%和36.4%,胃癌组织中的阳性表达率显著低于单纯肠化组织(χ2=12.9470,P<0.05),而与不典型肠化组织比较差异无统计学意义(χ2=2.7010,P>0.05)。PTEN蛋白在单纯肠化、不典型肠化及胃癌组织中的阳性表达率分别为86.9%、75.8%和47.7%,胃癌与单纯肠化之间差异有统计学意义(χ2=9.7885,P<0.05)。结论:CDX2蛋白异常表达参与了胃黏膜肠化及癌变的过程,PTEN蛋白对CDX2蛋白的表达可能起到一定的调节作用;不典型肠化与胃癌的关系密切,属癌前病变范畴。将肠化分类方法应用于不典型肠化患者的初步筛选,有望提高早期胃癌的检出率。

Objective： To study the relationship of expression of CDX2 and PTEN proteins and gastric metaplasia. Methods： Immunohistochemistry Envision method was used to detect the expression of CDX2 and PTEN proteins in simple intestinal metaplasia （SIM）, atypical intestinal metaplasia （AIM） and gastric adenocarcinoma. Results： The positive rates of CDX2 in SIM, AIM and gastric adenocarcinoma was 82.6%, 51.5% and 36.4% respectively. The expression of CDX2 ingastric adenocarcinoma was significantly lower than that in SIM （P〈0.05）,while there was no significant difference between AIM and gastric adenocarcinoma （P〉0.05）. The positive rates of PTEN in SIM, AIM and gastric adenocarcinoma were 86.9%,75.8%and 47.7% respectively and the difference between SlM and gastric adenocarcinoma was significant （P〈0.05）. Conelusions： CDX2 protein plays an important role in gastric meteplasia. PTEN might be related with the expression of CDX protein.