胃泌素、环氧合酶2不在同胃黏膜病变中的表达及意义

Expression of gastrin and cyclooxygenase2 in different gastric mucosal lesions

目的研究不同胃黏膜病变组织中胃泌素、环氧合酶2（COX-2）和Ki-67的表达，探讨胃泌素和COX-2在胃黏膜癌变过程中的作用及其相互关系。方法96例不同胃黏膜病变组织来自胃镜活检标本。采用免疫组化染色EnVision法检测胃泌素、COX-2和Ki-67表达。结果胃泌素在慢性浅表性胃炎（CSG）、慢性萎缩性胃炎（CAG）、肠上皮化生（IM）、异型增生（Oy）和胃癌（GC）中表达的阳性率分别为58．8％、30．0％、57．9％、68．2％和77．8％，CAG组与GC组比较，差异有统计学意义（P〈0．05）。COX-2在CSG、CAG、IM、Dy和GC中表达的阳性率分别为41．2％、45．0％、68．4％、72．7％和88．9％；在GC中的表达显著高于CSG（P〈0．05）。从CSD→GC，Ki-67增殖指数（PI）呈逐渐递增趋势；从CAG→GC，胃泌素和COX-2的表达与PI呈正相关（P〈0.05）。在胃癌前期病变中，胃泌素与COX-2表达有显著相关性（γ=0．4108，P〈0．01），二者共同表达时，PI显著升高。结论CAG中胃泌素呈低表达，从CAG→GC，胃泌素表达逐渐升高。在胃黏膜癌变过程中，COX-2表达呈逐渐递增趋势。在胃癌前病变阶段，胃泌素和COX-2协同促进细胞增殖，胃泌素可能参与上调COX-2的表达。

Objective To investigate the expression of gastrin,eyclooxygenase-2（COX-2） and Ki-67 in different gastric mucosal lesions and to assess the role of gastrin and COX-2 in the sequence of gastric carcinogenesis and its relationship. Methods 96 samples with different gastric mucosal lesions were obtained by gastroscope. The expression of gastrin,COX-2 and Ki-67 was examined with immunohistochemical staining technique l EnVision）. Resuits Positive rates of gastrin expression in chronic superficial gastritis （CSG） ,chronic atrophic gastritis （CAG ）, intestinal metaplasia（ IM） ,dysplasia（ Dy） and gastric cancer GC） were 58.8 % ,30.0% ,57.9 % ,68.2% and 77.8%, respectively, and there were significant differences between GC and CAG（P 〈 0.05 ）. Positive rates of COX- 2 expression in CSG,CAG,IM,Dy and GC were 41.2 % ,45.0% ,68.4 % ,72.7% and 88.9% respectively,and there were significant differences between GC and CAG（ P 〈0.051. Ki-67 proliferation index （P I） from CSG,CAG, IM, Dy to GC also had an increasing tendency. From CAG to GC, the expression of gastrin and COX- 2 was positively correlated with PI （ P 〈 0.05 ）. The expression between gastrin and COX-2 was correlated significandy in gastric precancerous lesions （ P 〈 0.01 ）. PI was increased significantly in group with co-expression of gastrin and COX-2. Conclusion Gastrin expression is decreased in CAG. From CAG to GC, gastrin expression is increased gradually. COX- 2 expression has an increasing tendency in the sequence of gastric cancerization. From CSG to GC, PI is gradually increased. Gastrin and COX-2 co-promote proliferation of gastric epithelial cells, and gastrin may take part in up-regulation of COX-2 expression in gastric precancerous.