幽门螺杆菌感染对胃上皮细胞增殖和凋亡的影响

Effect of Helicobacter pylori infection on gastric epithelial cell proliferation and apoptosis

目的为了探讨幽门螺杆菌感染对胃粘膜上皮细胞动力学的影响。方法应用免疫组织化学和切口末端标记法（ＴＵＮＥＬ），检测了１６例正常胃粘膜者和３１例幽门螺杆菌（Ｈｐ）相关慢性胃炎患者治疗前后胃粘膜上皮细胞增殖细胞核抗原（ＰＣＮＡ）标记指数（ＬＩ％）、细胞凋亡指数（ＡＩ）和表皮生长因子受体（ＥＧＦ－Ｒ）的表达。结果Ｈｐ阳性患者的ＰＣＮＡＬＩ％为１３．９４±１．６４，正常对照组为６．７１±０．９２，差异有非常显著性（Ｐ＜０．０１）；ＥＧＦ－Ｒ表达与ＰＣＮＡＬＩ％呈正相关（ｒ＝０．４４８７，Ｐ＜０．０１）：Ｈｐ阳性患者组的ＡＩ为７．１±１．６，正常对照组为１．３±０．６，差异有非常显著性（Ｐ＜０．０１）；抗Ｈｐ治疗后，２１例Ｈｐ根除者的ＰＣＮＡＬＩ％和细胞ＡＩ分别降至８．２１±１．３２和１．２±０．６，与治疗前相比差异有非常显著性（Ｐ＜０．０１），而１０例Ｈｐ持续阳性者则无明显降低（Ｐ＞０．０５）：ＰＣＮＡＬＩ％、ＥＧＦ－Ｒ表达及细胞ＡＩ与胃粘膜炎症程度无显著相关（Ｐ＞０．０５）。结论上述结果提示，Ｈｐ感Ｈ能引起胃粘膜上皮细胞过度增殖和凋亡。这为Ｈｐ感染胃癌发病中的作用机制提供了一些线索。

Objective To investigate whether H. pylori infection has any effect on the cell kinetics of gastric epithelium. Methods Gastric biopsy specimens were taken from thirty-one patients with H .pylori associated chronic gastritis before and after anti-H. pylori therapy and from sixteen H. pylori negative normal controls. Immunohistochemical staining of PCNA and the method of terminal uridine deoxynucleotide nick end labeling (TUNEL) were used to detect the status of gastric epithelial proliferation and apoptosis . Results PCNA labeling -index (LI) % was 13.94± 1.64 in H. pylori positive patients, significantly higher than 6.71 ±0.92 in normal controls (P<0.01); Epidermal growth factor receptor (EGF-R) staining was positively correlated with PCNA LI% (r=0.4487,P<0.01). The apoptotic index (AI) in patients with H. pylori infection was 7.1± 1.6, significantly higher than 1.3 ±0.6 in normal controls (P< 0.01). After anti-H . pylori triple therapy, PCNA LI% and AI in 21 patients with H . pylori eradication significantly declined to 8.2 1 ±1 .32 and 1.2± 0.6 respectively (P<0.01), whereas those were unaltered in 10 patients with failure of H. pylori eradication (P>0.05), as compared with those before treatment. Conclusions These results suggest that H. pylori infection causes increased gastric epithelial proliferation and apoptosis , and by this way it may play a part in gastric carcinogenesis . [