胃粘膜萎缩与肠化的细胞增殖和凋亡研究

Study on the correlation between proliferation and apoptosis in atrophy and intestinal metaplasia of gastric mucosa

目的 研究胃粘膜萎缩和广泛肠化的细胞增殖与凋亡的定量关系。 方法 CSG14例,CAG11例,CAG+IM20例,对照5例,分别作HE染色,ISEL检测细胞凋亡,免疫组化PCNA和bcl-2抗体染色。求各组增殖指数(PI)、凋亡指数(AI)、凋亡增殖比和凋亡强度。 结果 各组PI和AI分别是:15.4％,24.8％,56.9％和8.4％,5.4％,11.6％,1.9％和1.4％;在CSG,CAG凋亡和增殖呈正相关(r=0.5475和0.5839),CAG凋亡强度最大;CAG+IMPI最高,但凋亡和增殖呈负相关(r=-0.6742),凋亡强度异常低,不足对照组的1/5,CSG的1/10,CAG的1/4。 结论 CAG的萎缩可能是过度凋亡所致;CAG+IM则出现凋亡障碍,过度增殖,与异型增生和癌的细胞生物学表现相似。

AIM To study the correlation between proliferation and apoptosis in atrophy and intestinal metaplasia of gastric mucosa.METHODS Gastric biopsy specimens from 14 patients with CSG, 11 patients with CAG, 20 patients with CAG+ IM and 5 normal cases were used to investigate proliferation index (PI), apoptosis index (Al), apoptosis/proliferation ratio and apoptosis degree in every group by in situ end-labelling (ISEL) and immunohistochemical technique with PCNA and bcl-2 antibodies.RESULTS The PI and Al of each group were 15.4%, 24.8%, 56.9% and 8.4%, 5.4%, 11.6%, 1.9% and 1.4% respectively. Apoptosis and proliferation in CSG and CAG were positively correlated (r = 0.5475 and 0.5839). In CAG the apoptosis degree was most intensive. In CAG + IM the PI was the highest, but the apoptosis was very low, only a fifth of normal control, a tenth of CSG, and a fourteenth of CAG. Apoptosis and proliferation was negatively correlated (r= -0.6742). CONCLUSION The atrophy of gastric mucosa may be caused by excessive apoptosis. The gastric mucosa with CAG+ IM shows excessive proliferation and impediment of apoptosis, which are similar to the cytobiological expression of gastric dysplasia and carcinoma.