胃癌及肠化组织微卫星不稳定性

Microsatellite instability in gastric carcinoma and intestinal metaplasia

目的研究微卫星不稳定性（ＭＳＩ）在胃癌发生、发展中的作用。方法采用聚合酶链反应（ＰＣＲ）方法检测了５０例手术切除胃癌标本及１５例肠化标本的ＭＳＩ。结果５０例胃癌中有２７例检出１个以上位点ＭＳＩ，总阳性率为５４０％；高中分化腺癌ＭＳＩ检出率（８６．６％）显著高于低分化腺癌（３８．７％，Ｐ＜０．０５）；肠型胃癌ＭＳＩ阳性率（７７．８％）显著高于胃型胃癌（４００％，Ｐ＜０．０５）；ＭＳＩ与胃癌发病年龄、大小、发生部位、浸润深度、淋巴结转移及临床分期无显著相关。３例早期胃癌ＭＳＩ均阳性，１５例肠化标本中有３例检出ＭＳＩ，阳性率为２０％。结论ＭＳＩ是胃癌发生过程中的早期分子标志，在胃癌的发生中可能扮演重要角色。

Objective To investigate the role of microsatellite instability (MSI) in the carcinogenesis and development of gastric cancer (GC). Methods MSI was examined in 50 surgically resected gastric cancer specimens and 15 intestinal metaplasia specimens using PCR based methods. Results MSI was detected in 27/50 of GC and 3/15 of intestinal metaplasia at one or more loci. MSI was positive in all three cases of early GC. The incidence of MSI in well differenciated GC (86.6%) was significantly higher than that in poorly differentiated GC ( P <0.05). The frequency of MSI in intestinal type of GC (77.8%) was significantly higher than that in the diffused type (40%, P <0.05). No significant correlation was found between MSI and age, sex, size, location, lymph node metastasis or clinical stage of GC. Conclusion MSI is an early molecular marker in the carcinogenesis of GC and may play an important role in the development of GC.