胃癌及癌前病变细胞凋亡与Caspase-9，Bax表达的关系

Relationship between the.expression of Caspase -9, Bax gene and cell apoptosis in gastric carcinoma and precancerous lesions

目的：探讨细胞凋亡基因Caspase-9和Bax在胃癌前病变和胃癌发展中的作用。方法：应用免疫组化S—P法检测Caspase-9和Bax在57例胃癌及48例非癌胃黏膜组织的表达，用原位末端标记法（TUNEL法）检测相应胃组织细胞凋亡。结果：Caspase-9蛋白在非癌胃黏膜组（慢性浅表性胃炎、慢性萎缩性胃炎、肠上皮化生、不典型增生）阳性表达率分别为100．00％、86．67％、50．00％、42．85％，呈逐渐下降趋势。慢性浅表性胃炎组中Caspase-9蛋白阳性表达率与肠上皮化生、不典型性增生有显著性差异（P〈0．05），肠上皮化生组Caspase-9蛋白阳性表达率高于不典型增生组，但无统计学差异（P〉0．05）。Bax蛋白在48例非癌胃组织中的阳性表达率分别为：慢性浅表性胃炎100．00％、慢性萎缩性胃炎80．00％、肠上皮化生56．25％、不典型增生57．14％，呈逐渐下降趋势，其中慢性浅表性胃炎组Bax蛋白阳性表达率与肠上皮化生、不典型增生有显著性差异（P〈0．05）。慢性浅表性胃炎、慢性萎缩性胃炎、肠匕皮化生、不典型增生、胃癌组织中，AI值（细胞凋亡指数）分别为（14．72±2．68）％、（10．02±2．34）％、（7．55±2．80）％、（6．09±2．35）％、（3．26±1．23）％，呈逐渐下降趋势，有显著性差异（P〈0．05）。结论：Caspase-9和Bax可能参与胃癌癌前病变的形成，促进胃癌的发生。

Objective：To evaluate the function of Caspase -9 and Bax in gastric carcinoma and precancerous lesions. Methods ：Immunohistochemistry SP was used to detect the expression of Caspase - 9 and Bax in 57 patients with gastric carcinoma and 48 patients without gastric carcinoma. Tumor cell apoptosis was detected with TUNEL method. Results：The positive expression of Caspase - 9 protein in non gastric carcinoma tissue including chronic superficial gastritis, chronic atrophic gastritis, intestinal metaplasia, atypical hyperplasia were 100.00% ,86.67%, 50.00% and 42.85% respectively, with decreasing tendency （ P 〈 0.05 ）. The positive expression of Caspase - 9 protein in chronic superficial gastritis was significantly higher than in intestinal metaplasia and atypical hyperplasia （ P 〈 0.05 ）. The positive expression of Caspase - 9 protein in intestinal metaplasia was higher than in atypical hyperplasia but there was no significant difference （ P 〉 0.05 ）. The apoptosis index in chronic superficial gastritis, chronic atrophic gastritis,intestinal metaplasia, atypical hyperplasia and gastric carcinoma were （ 14.72 ± 2.68） %, （ 10.02 ± 2.34） %, （7.55 ± 2.80） %, （6.09 ± 2.35） %, and （3.26 ± 1.23 ） %, which demonstrated decreasing tendency and the difference was significant （ P 〈 0.05 ）. Conclusion： Caspase - 9 and Box were allelerate gastric, carcinoma and concerned with precancerous lesions.