幽门螺杆菌相关性胃病的细胞增殖与凋亡的研究

Study on the gastric epithelial cell proliferation and apoptosis in Helicobacter pylori associated diseases of the stomach

目的：观察幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒ ｐｙｌｏｒｉ，Ｈｐ）感染对其相关性胃病的细胞增殖与凋亡的影响，进而探讨胃癌的发生机理。方法：研究对象为正常人（ｎｏｒｍａｌ ｓｕｂｊｅｃｔｓ，ＮＳ）及慢性浅表性胃炎（ｃｈｒｏｎｉｃ ｓｕｐｅｒｆｉｃｉａｌｇａｓｔｒｉｔｉｓ， ＣＳＧ）、慢性萎缩性胃炎（ｃｈｒｏｎｉｃ ａｔｒｏｐｈｉｃ ｇａｓｔｒｉｔｉｓ， ＣＡＧ）、慢性萎缩性胃炎伴肠上皮化生 （ｃｈｒｏｎｉｃ ａｔｒｏｐｈｉｃｇａｓｔｒｉｔｉｓ ｗｉｔｈ ｉｎｔｅｓｔｉｎａｌ ｍｅｔａｐｌａｓｉａ，ＣＡＧＩＭ）、不典型增生（ｄｙｓｐｌａｓｉａ， ＤＹＳ）、胃癌（ｇａｓｔｒｉｃ ｃａｎｃｅｒ， ＧＣ） Ｈｐ阳性与阴性患者，共计１１组，每组１０例。细胞凋亡检测采用Ｔｕｎｅｌ方法，细胞增殖检测采用免疫组化ＬＳＡＢ方法测定增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇ ｃｅｌｌ ｎｕｃｌｅａｒ ａｎｔｉｇｅｎ，ＰＣＮＡ）。结果： ＣＳＧ Ｈｐ阳性患者细胞凋亡指数（ａｐｏｐｔｏｓｉｓ ｉｎｄｅｘ， ＡＩ）明显高于Ｈｐ阴性患者（ Ｐ＜０．０５），其余４种胃病 Ｈｐ阳性与阴性的患者 ＡＩ比较均无显著性差异（Ｐ＞ ０．０５）； ＣＳＧ、 ＣＡＧ。

Objective: To investigate whether Helicobacter pylon (Hp) would have any effects on the gastric epithelial cell proliferation and apoptosis, and a role in the pathogenesis of gastric cancer. Methods: Endoscopic gastric mucosal biopsies were taken from 1 group (10 cases) of normal subjects (NS) and 10 groups (10 cases for each group) of patients with chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), chronic atrophic gastritis with intestinal metaplasia (CAGIM) or dysplasia (DYS), and gastric cancer (GC) with or without Hp infection. Apoptosis cells in the gastric mucosa were quantitated after terminal deoxynucleatidyl transferase mediated dUTP nick and labelling (TUNEL method) and proliferation cells after immunohistochemieal staining (LSAB method) of proliferating cell nuclear antigen (PCNA). Results: Apoptosis index (AI) of the patients with Hp positive CSG group was much higher than that of the patients with Hp negative CSG group (P < 0.05). There was no significant difference between the patients with or without Hp infection of the other four groups (P > 0. 05). PCNA Labelling indices (PCNA-LI) of the patients with Hp positive CSG, CAG, CAGIM, and GC groups were significantly higher than these of the patients with Hp negative groups, respectively (P < 0. 05). There was no significant difference of Al/PCNA-LI ratio between the NS group and CSG group (P > 0. 05 ), but the Al/PCNA-LI ratio of these two groups was much higher than that of the CAb, CAGIM, DYS and GC groups (P < 0. 05). Conclusion: Hp infection might induce apoptosis and thereby stimulate proliferation of the gastric epithelial cells, these effects might lead to the imbalance of the Al/PCNA ratio and ultimately promote the development of gastric cancer.