幽门螺杆菌L型感染与胃癌发生发展关系的研究

Study on the relationship between Helicobacter pylori L-form infection and the genesis and development of gastric carcinoma

目的：研究幽门螺杆菌L型（Helicobacter pyloriL-form,Hp-L型）感染在胃癌发生、发展中的作用。方法：收集慢性萎缩性胃炎、胃肠上皮化生、胃不典型增生、胃腺癌标本各40例,以40例慢性浅表性胃炎（轻度）作为对照。应用革兰染色和免疫组织化学SP法检测Hp-L型的感染情况;应用SP法和原位杂交法检测上述组织的癌基因细胞S期激酶相关蛋白2（skp2）的表达,检测Ki-67和p53等的表达情况。结果：慢性萎缩性胃炎、胃肠腺化生、胃不典型增生和胃癌组织的Hp-L型阳性率分别为22.5%、40.0%、65.0%和55.0%,除胃癌组外其他病变组Hp-L型阳性率呈逐渐增高趋势。Hp-L型阳性组的skp2mRNA、Ki-67和p53在胃癌组阳性表达率与对照组相比均具有统计学意义（P〈0.05-P〈0.01）。结论：Hp-L型感染可能在慢性萎缩性胃炎→胃肠上皮化生→胃不典型增生→胃癌这一演变过程中起着重要作用,从而与胃癌的发生相关。其促进胃癌发生、发展的机制可能涉及上调skp2、Ki-67和突变p53的表达。

Objective：To investigate the role of Helicobacter pylori L-form（Hp-L）in the genesis and development of gastric carcinoma.Methods：The specimens of chronic atrophic gastritis（CAG）,intestinal metaplasia（IM）,gastric epithelial dysplasia（GED）and gastric carcinoma（GCa）were collected from each 40 cases,and 40 cases of chronic superficial gastritis（CSG）（mild）acted as control.Hp-L was examined in each group by Gram＇s staining and immunohistochemical stain（SP method）;The expression of skp2 was detected by Immunohistochemistry（IHC）and ISH,and the expression of Ki-67 and p53 were also examined by IHC.Results：The positive rates of Hp-L in CAG,IM,GED and GCa were 22.5%,40.0%,65.0% and 55.0%,respectively,demonstrating an increasing trend except for GCa group.The positive rate of mRNA and protein of Skp2 in CAG,IM,GED and GCa in the positive Hp-L groups of GCa were higher than that in the negative groups.The difference had statistical significance（P〈0.05-P〈0.01）.Conclusions：Hp-L may play an important role in the evolution course of CAG,IM,GED and GCa,and correlates to the development of gastric carcinoma.Its mechanism of promoting the occurrence and development of gastric carcinoma may up-regulate the expressions of skp2,Ki-67 and mutant p53.