幽门螺杆菌感染和尾型同源盒转录因子2、黏蛋白2表达与胃癌的关系

Relationship between Helicobacter pylori infection,expression of caudal-related homeobox transcription factor 2,mucin 2 proteins and gastric cancer

目的研究幽门螺杆菌（Hp）感染、尾型同源盒转录因子2（CDX2）、黏蛋白2（MUC2）表达与胃癌的关系及检测CDX2、MUC2对判断胃癌预后的意义。方法90例胃癌标本，应用Warthin—starry硝酸银染色检测Hp及免疫组织化学SP法检测CDX2、MUC2蛋白表达，并以10例正常胃黏膜作为对照。结果正常胃黏膜内未检测到Hp，CDX2、MUC2蛋白不表达。Hp及CDX2、MUC2蛋自在肠型胃癌患者中的阳性率分别为67．86％（38／56）、75．00％（42／56）、66．07％（37／56），显著高于弥漫型胃癌患者[35．29％（12／34）、41．18％（14／34）、38．24％（13／34）]（P〈0．01或〈O．05）；在肠型胃癌患者中，CDX2、MUC2蛋自在Hp阳性患者阳性率明显高于Hp阴性患者（P〈0．01或〈0．05）。在弥漫型胃癌患者中，CDX2蛋白在Hp阳性患者阳性率也显著高于Hp阴性患者（P〈0．05）；CDX2、MUC2蛋白在早期、无淋巴结转移患者阳性率显著高于中晚期、有淋巴结转移患者（P〈0．01或〈0．05）；CDX2蛋白在I～Ⅱ期患者的阳性率也显著高于Ⅲ～Ⅳ期患者（P〈0．05）。结论Hp感染及CDX2、MUC2蛋白异常表达与胃癌的发生有关，与肠型胃癌关系密切；CDX2、MUC2蛋白可能对胃癌的浸润和转移有抑制作用。

Objective To study the significance of Helicobacter pylori （Hp） infection and the expression of caudal-related homeobox transcription factor 2 （CDX2）, mucin 2 （MUC2） proteins in gastric cancer, and elucidate the prognostic significance of CDX2,MUC2 proteins in gastric cancer. Methods Ninety cases of gastric cancer were available for the study. Hp wzs studied by Warthin-Starry bacterium stain and CDX2 and MUC2 proteins were studied by immunohistochemical stain. Results There was no Hp infection and no expression of CDX2 and MUC2 proteins in normal gastric mucosa. The positive rate in the cases of intestinal-type gastric cancer was 67.86% （ 38/55 ） for Hp, 75.00% （42/56） for CDX2, and 66.07% （37/56） for MUC2, respectively, and it was higher than that in the cases of diffuse-type gastric cancer, which was 35.29%（12/34） ,41.18% （14/34） and 38.24% （13/34） respectively （P〈 0.01 or 〈 0.05 ）. In intestinal- type gastric cancer ,the positive rate of CDX2 and MUC2 proteins was also higher in Hp positive cases than that in Hp negative cases, and it was the same as CDX2 protein in diffuse-type gastric cancer. Higher positive rates of CDX2 and MUC2 proteins were observed in the cases of early gastric cancer than those in the cases of advanced gastric cancer （P 〈 0.01 or 〈 0.05 ）, also it was observed in the cases of no lymph node metastasis than in the cases of lymph node metastasis （P 〈 0.01 or 〈 0.05 ）. Moreover, the positive rate of CDX2 protein in the cases of stage Ⅰ -Ⅱ was higher than that in the cases of stage Ⅲ～Ⅳ （P〈O.05）. Conclusions Hp infection and the expression of CDX2 and MUC2 proteins are related with gastric cancer,and has close relationship with intestinal-type gastric cancer. The expressions of CDX2 and MUC2 proteins may inhibit the infiltration and metastasis of gastric cancer.