尾侧型同源转录因子2、肝肠钙粘连蛋白在肠型胃癌及胃黏膜肠上皮化生组织中的表达及意义

Expression of Cdx2 and Ll-cadherin in intestinal metaplasia of gastric mucosa and gastric adenocarcinoma of the intestinal type

目的 探讨尾侧型同源转录因子2（caudal type homeobox transcription factor2，Cdx2）及肝肠钙粘连蛋白（liver intestinal cadhefin，LI—CD）在肠型胃癌及胃黏膜肠上皮化生组织中的表达、相关性以及临床意义。方法随机选取胃镜黏膜活检标本，肠型胃癌组、肠上皮化生组及非肠化生非胃癌对照组各30例，进行Cdx2及LI—CD免疫组化染色，并对染色结果进行分析。结果Cdx2在正常胃黏膜上皮、胃黏膜肠上皮化生和肠型胃癌组的阳性表达率分别为0、93．3％和46．7％，其在肠上皮化生组和胃癌组的表达显著高于正常黏膜组（P〈0．005），在肠上皮化生中表达显著高于胃癌组（P〈0．005）。LI—CD在正常胃黏膜上皮、胃黏膜肠上皮化生和胃癌的阳性表达率分别为0、96．7％和73．3％，其在肠上皮化生组和胃癌组的表达显著高于正常黏膜组（P〈0．005），在肠上皮化生中表达显著高于胃癌（P〈0．05）。此外，LI—CD在胃黏膜肠化生中的表达强度与Cdx2显著相关（r=0．827，P〈0．01），而二者在胃癌组中则缺乏相关性（r=0．438，P=0．117）。结论Cdx2和LI—CD蛋白在胃黏膜肠上皮化生和肠型胃癌组织中存在异位表达，可作为胃黏膜肠上皮化生和胃癌的早期标志；在人的胃黏膜肠上皮化生组织中Cdx2与LI—CD具有相关性，并推测其在胃黏膜肠上皮化生发生发展中cdx2对LI—CD具有调控作用。

Objective To explore the expression of caudal type homeobox transcription factor 2 （Cdx2） and liver intestinal cadherin （LI-CD） in intestinal metaplasia （IM） of gastric mucosa and gastric adenocarcinoma of the intestinal type （GAIT）. Methods By using immunohistoehemical method, the expressions of Cdx2 and LI-CD were detected in biopsy sample including 30 cases of GAIT, 30 IM and 30 normal controls. Results The positive rate of Cdx2 expression was 0, 93.3% and 46.7% in normal stomach mucosa, IM and GAIT, respectively. The positive rates of Cdx2 expression in IM and GAIT were significantly higher than that in normal stomach mucosa （ P 〈 0. 005 ） , and the expression of Cdx2 in IM was significantly higher than that in GAIT （P 〈0. 005）. Similarly, LI-CD was also negative in normal stomach mucosa, and positive rates were 96. 7% and 73.3% in IM and GAIT group, which were significantly higher than that in normal stomach mucasa （ P 〈 0. 005 ） , and LI-CD expression was also significantly higher in IM than in GAIT （P 〈 0. 05 ）. In addition, the staining intensity of Cdx2 and LI-CD expressions in IM exhibited significant correlation （ r =0. 827, P 〈 0. 01 ）, but those in GAIT did not （ r = 0. 438, P = 0. 117 ）. Conclusion Eetopic expression of Cdx2 and LI-CD can be found in IM and GAIT tissues, which could be an early marker in the disease progression. There is correlation between Cdx2 and LI-CD exorcssion in IM tissue of human, and presumably, Cdx2 regulates LI-CD in IM development.