胃粘膜肠化中幽门螺杆菌感染与PCNA,c-erbB-2的表达

PCNA and c erbB 2 expression in gastric mucosal intestinal metaplasia with Helicobacter pylori infection *

目的研究肠化胃粘膜幽门螺杆菌（Ｈｐ）阳性率与ＰＣＮＡ，ｃｅｒｂＢ２表达率之间关系，以探讨Ｈｐ感染在胃肠化发生、发展中作用．方法经病理检查证实的慢性胃炎伴肠化１１６例，对照组非溃疡性消化不良．应用改良ＷａｒｔｈｉｎＳｔａｒｙ法检测Ｈｐ，免疫酶组化ＳＰ法检测ＰＣＮＡ，ｃｅｒｂＢ２的表达，比较Ｈｐ阳性组和阴性组间ＰＣＮＡ，ｃｅｒｂＢ２的阳性表达率．结果胃粘膜肠化者Ｈｐ感染率增高（５８６％ｖｓ１８８％，χ２＝１０７９，Ｐ＜００１），肠化胃上皮内少见Ｈｐ粘附，Ｈｐ阳性组ＰＣＮＡ，ｃｅｒｂＢ２表达高于阴性组（４８／６８ｖｓ１２／４８，χ２＝９０５，Ｐ＜００５；３６／７４ｖｓ２／４２，χ２＝１３２８，Ｐ＜００１）．结论Ｈｐ感染促进胃粘膜肠化，并使肠化胃粘膜细胞增殖迅速而启动恶性变，故Ｈｐ感染可能促进胃癌的形成．

AIM To study the prevalence of Helicobacter pylori (Hp) and the relation between expression of PCNA, c erbB 2 and Hp infection in gastric mucosa with intestinal metaplasia to evaluate the role of Hp infection in morphogenesis and development of intestinal metaplasia. METHODS Pathologically confirmed 116 cases of chronic gastritis with intestinal metaplasia and 32 controls of non ulcer dyspepsia were studied. Hp was detected by using improved Warthin Starry method and PCNA, c erbB 2 were examined by using immunohistochemical method (SP system). The expressions of PCNA and c erbB 2 were studied in Hp positive and Hp negative patients. RESULTS The prevalence of Hp increased significantly in gastric mucosa with intestinal metaplasia (58 6% vs 18 8%, χ 2=10 79, P <0 01), but Hp rarely colonized in gastric epithelium with intestinal metaplasia. The expressions of PCNA and c erbB 2 in Hp positive patients was significantly higher than those in Hp negative patients (48/68 vs 12/48 , χ 2=9 05, P <0 05; 36/74 vs 2/42 , χ 2=13 28, P <0 01). CONCLUSION Hp plays a promotional role in morphogenesis of intestinal metaplasia, and stimulates cell over proliferation and gastric epithelium malignant change. So Hp infection may play an important role in gastric carcinogenesis.