老年患者的幽门螺杆菌（HP）感染与胃癌及癌前病变中C-myc、p16、p53、K-ras和C-erbB-2基因表达

Expression of C-myc. p16. p53. K-ras and C-erb B-2 and Helicobacter pylori infection in Gastric Cancer and Precancerous Lesion in elderly patients

目的探讨老年患者幽门螺杆菌（HP）感染与胃癌及癌前病变中C-myc、p16、p53、K-ras和C．erbB-2基因表达及其临床意义。方法分析老年患者的胃镜检查活检标本116例，HE染色观察胃黏膜的炎症和异型增生变化，特染法检测胃黏膜的肠上皮化生，应用Warthin-stary银染色法检测HP，应用ELISA法检测血清学HPIgG，14C尿素呼气试验（14C-UBT）检测HP，应用免疫组化sP法检测C-myc、p16、p53、K-ras和C-erbB-2基因的表达。结果老年患者在不同胃组织中C-myc、p16、p53基因的表达均有显著差异，而K-ras和C-erbB-2基因表达未见显著性差异。HP感染率以胃癌为最高，其次为胃溃疡。结论本实验通过老年患者的HP检测和观察胃黏膜的炎症和异型增生变化，再结合癌基因和抑癌基因的表达异常，提示萎缩性胃炎异型增生、肠上皮化生和胃癌的HP感染率均高于非萎缩性胃炎。再次表明胃癌与HP感染有一定相关性。

Objective To explore the clinical significance of helicobacter pylori infection and expression of C-myc, pl6, p53, K-ras and C-erb B-2 in gastric cancer and precancerous lesion in elderly patients. Methods 116 biopsy specimens from gastric mucosa in elderly patients were analysed. The gastric mucosa inflammation and dysplasia was detected by HE staining, intestinal metaplasia was observed by particular staining, and helicobacter pylori was eamined by Warthin-stary silver staining. Serum HP IgG was detected by ELISA. Helicobacter pylori was analysed by 14C-UBT. The expression of C-myc, pl6, p53, K-ras and C-erb B-2 was observed by SP method. Results In different gastric tissues in elderly patients, there were significant differences of C-myc, pl6 and p53 expressions, but there were no differences of k-ras and C-erb B-2 expressions. The infection rate was the most in gastric cancer, followed by gastric ulcer. Conclusions This experiment in elderly patients with helicobacter pylori detection and observation of gastric mucosal inflammation and dysplasia, combined with the expression of oncogen and anti-oncogene is abnormal, suggested that atrophic gastritis dysplasia, intestinal metaplasia and gastric cancer, HP infection rates were higher than the non-atrophic gastritis. There is the correlaton between liP infection and gastric carcinoma.