胆汁返流与胃黏膜肠化生以及CDX2表达的关系

THE RELATIONSHIP AMONGBILE REFLUX,GASTRIC INTESTINAL METAPLASIA AND CDX2

目的探讨胃黏膜肠化生与胆汁返流的关系以及CDX2在此中的作用。方法对145例行胃镜检查且有组织学检查的慢性浅表性胃炎、97例慢性浅表性胃炎伴有胃黏膜胆汁染色以及91例胃大部切除术后的患者的临床资料进行统计分析,并随机对60例胃黏膜肠化生者行CDX2免疫组化染色。结果慢性浅表性胃炎伴有胆汁返流肠化生的发生率为51.54%,显著高于单纯浅表性胃炎组的30.02%(P<0.01);胃大部切除术后肠化生的发生率仅为3.52%;胆汁返流性胃炎伴有肠化生组CDX2的阳性率为89.47%,高于单纯性胃炎伴有肠化生组的54.54%(P<0.05),在非肠化生组CDX2呈阴性表达。结论胆汁返流是胃黏膜肠化生的病因之一,其主要机制可能与启动CDX2基因的表达有关。

Objective To explore the relationship among bile reflux, gastric intestinal metaplasia and CDX2. Methods The clinical data of 145 cases of chronic superficial gastritis confirmed by gastroscopy and histological examination, 97 cases of chronic superficial gastritis and bile reflux and 91 cases of subtotal gastrectomy were statistically analyzed. Immunohistochemical staining of gene CDX2 in 60 cases of gastric intestinal metaplasia was performed. Results The incidence rate of chronic superficial gastritis and bile reflux was 51.54% and that of simple chronic shallow gastritis was 30.02% （ P 〈0.01）. The incidence rate of intestinal metaplasia after subtotal gastrectomy was 3.52 %. The positive rate of CDX2 of the group of bile reflax gastritis and intestinal metaplasia was 89.47 % and that in the group of simple gastritis and intestinal metaplasia was 54.54 % （ P 〈 0.05）, while the non - intestinal metaplasia group showed negative expressions. Conclusion Bile reflux is one of the factors causing gastric intestinal metaplasia, and the mechanism may be related to the onset of the expressions of CDX2.