幽门螺杆菌感染和maspin基因表达与胃癌相关性的研究

Association study among Helicobacter pylori infection,maspin expression and gastric carcinoma

目的:探讨幽门螺杆菌(Hp)感染和maspin基因表达与胃癌发生发展的关系。方法:Grams染色和改良W-S银染法观察65例浅表性胃炎、58例癌前病变和79例胃癌黏膜组织中Hp感染情况,免疫组化技术检测不同胃黏膜组织maspin基因表达产物。结果:胃癌组、癌前病变组Hp感染率分别是79.7%(63/79)、58.6%(34/58),均明显高于慢性浅表性胃炎组的30.8%(20/65),χ2值分别为35.034、9.645,P值分别为0.000、0.002;胃癌组Hp感染率高于癌前病变组,χ2=7.221,P=0.007。Maspin蛋白表达在浅表性胃炎、癌前病变及胃癌中阳性率分别是58.5%(38/65)、82.8%(48/58)和32.9%(26/79),浅表性胃炎和癌前病变组maspin表达均高于胃癌组,χ2值分别为9.428、33.457,P值分别为0.002、0.000;癌前病变组织中maspin表达高于浅表性胃炎,χ2=8.603,P=0.003。在浅表性胃炎、癌前病变及胃癌组织中,Hp感染阳性组maspin表达阳性率均较Hp感染阴性组低,且差异有统计学意义,χ2值分别为6.548、26.619和4.950,P值分别为0.010、0.000和0.029。胃癌组织中maspin蛋白的表达与肿瘤分化程度、周围组织浸润及淋巴结是否发生转移显著相关,P值分别为0.017、0.033和0.006。结论:Hp感染在胃黏膜演变过程中起着重要作用,Hp感染可能通过使maspin基因失活从而诱发胃黏膜的癌变,maspin蛋白的表达失活可能是Hp致癌的作用机制之一。

OBJECTIVE： To study the association among Hp infection, maspin expression and gastric carcinoma. METHODS： Hp infections in different gastric mucosa were observed by Grams staining and modified W-S silver staining method. Maspin expressions were detected by immunohistochemical technology. RESULTS： Hp infection rates were 79.7 % （ 63/79）, 58.6 % （34/58） and 30.8 %（20/65） respectively in gastric carcinoma, lesion precancerous and chronic su perficial gastritis group. Infection rates were higher significantly in gastric carcinoma and lesion precancerous than those in chronic superficial gastritis （X2 = 35. 034,P = 0. 000, ;（x2=9. 645, P = 0. 002）. Infection rate was significantly higher in gastric carcinoma than that in lesion precancerous （x2 = 7. 221, P = 0. 007）. The positive rates of maspin were 58.5 （38/65）, 82.8 % （48/58）and 32.9 % （26/79）in different gastric mucosa respectively. The expression of maspin was lower in gastric carcinoma than those in chronic superficial gastritis and lesion precancerous （x2 = 9. 428, P= 0. 002; X2 =33. 457,P=0. 000） and in lesion precancerous was higher than those in chronic superficial gastritis （X2= 8. 603,P= 0. 003）. The maspin positive rates in Hp positive group were lower than those in Hp negative group （x2=6. 548,26. 619 and 4. 950 ,P=0. 010,0. 000 and 0. 029）. Maspin expression in the tissue of gastric carcinoma was significantly related to histological classification,invasive depth and metastasis of lymph node （P = 0. 017,0. 033 and 0. 006）. CONCLUSIONS： Hp infection may play an important role in the development of gastric mucosal lesion. Hp infection might induce gastric carcinoma by maspin gene inactivation.