胃癌前病变不同转归中p53、bcl-2基因的表达以及细胞增殖活性的研究

Expressions of p53, bcl-2 and proliferating cell nuclear antigen (PCNA) on different transformation in precancerous lesions of the stomach

目的 探讨p5 3、bcl 2基因和增殖细胞核抗原 (PCNA)等生物学指标在胃癌前病变不同转归中的作用。 方法 采用免疫组化 (LSAB)法检测 5 2例胃癌患者胃癌及癌前病变组织标本及 5 6例非胃癌患者癌前病变〔胃黏膜中度以上肠上皮化生和 (或 )异型增生〕组织标本的p5 3、bcl 2和PCNA的表达。 结果 (1)在癌前病变中 ,p5 3、bcl 2在癌组与非癌组之间的表达差异无显著性 (P >0 0 5 ) ,PCNA标记指数 (PCNALI)在癌组表达明显高于非癌组 ,差异有显著性 (P <0 0 1) ;(2 )p5 3、bcl 2和PCNA表达在胃癌组织均显著高于癌变前组织 (P <0 0 1) ;(3)在肠型胃癌 ,癌前p5 3、bcl 2阳性者到癌时仍全为阳性 ,无 1例转阴 ;在弥漫型胃癌 ,癌前bcl 2阳性者到癌时有 1例转阴。 结论 在肠型胃癌发生发展过程中 ,p5 3、bcl 2蛋白表达起重要作用 ,且发生癌变前细胞增殖活性已明显升高。

Objective To study the role of biological marks (p53, bcl 2 and PCNA) on different transformation in precancerous lesions of the stomach. Methods Immunohistochemical method (LSAB) was used to assess the expressions of p53, bcl 2 and PCNA in specimens from patients with (cancerous group, n=52) and without (non cancerous group, n=56) gastric cancer. Results (1) In precancerous lesions, there was no significant difference in p53 and bcl 2 expressions in cancerous group and non cancerous group (P>0.05), PCNA expression in precancerous group was higher than that in non cancerous group (P<0.01). (2) p53, bcl 2 and PCNA expressions in cancerous tissue were higher than those in precancerous group and non cancerous group (P<0.01). (3) In patients with intestinal type carcinoma, p53 and bcl 2 remained expressed in precancerous tissue after developed into cancer, no one was excluded. In diffuse type carcinoma, bcl 2 expression changed into negative from positive in one patient. Conclusions The expression of p53 and bcl 2 significantly influenced the development of intestinal type gastric carcinoma, and the proliferating activity had significantly increased before the occurence of gastric cancinoma.