幽门螺杆菌感染者细胞免疫应答及与胃癌的关系

Cellular immune response in gastric lesions associated with Helicobacter pylori infection and its correlation with gastric cancer

目的:探讨幽门螺杆菌(Hp)感染时不同疾病宿主Th1/Th2细胞免疫应答变化及与胃癌发生的相关性。方法:采用酶联免疫吸附法测定浅表性胃炎、胃癌前病变和胃癌患者血清γ干扰素(IFN-γ)及白细胞介素-4(IL-4)的水平,同时采用免疫组织化学方法检测3种疾病患者胃黏膜病变局部IFN-γ及IL-4的表达情况。结果:Hp阳性的浅表性胃炎患者血清IL-4水平较Hp阴性的浅表性胃炎患者明显降低(P<0.01);Hp阳性的浅表性胃炎、胃癌前病变及胃癌患者血清IL-4水平随病变的进展有逐渐升高的趋势,但3组间差异均无统计学意义(P>0.05),血清IFN-γ水平亦均无明显不同(P>0.05)。免疫组织化学检测发现IFN-γ在Hp感染的浅表性胃炎中表达较高(P<0.05),IL-4的表达与之相反,在Hp感染的胃癌组织中表达较高(P<0.05)。结论:胃病变局部Th1/Th2细胞免疫应答变化与Hp感染相关疾病的进展,特别是胃癌的发生密切相关。

Objective：To investigate the change of Th1/Th2 cellular immune response in patients with gastric lesions associated with Helicobacter pylori（Hp） infection and its correlation with the genesis of gastric cancer. Methods：Enzyme linked immunosorbent assay was employed to determine the levels of serum T-interferon （IFN-γ） and interleukin-4 （ IL-4 ） in patients with chronic superficial gastritis（CSG） ,preneoplastic gastric diseases （PGD） and gastric cancer（ GC ）. At the same time, immunohistochemisty staining was employed to determine the expression of IFN-γ and IL-4 in the gastric biopsies of the 3 groups. Results： The level of serum IL-4 in CSG with Hp infection was lower than that without Hp infection（P 〈0.01 ） ;the level of serum IL4 was elevated along with the progression of pathological changes in the cases of CSG, PGD and GC with Hp infection, but the difference was not significant among the three groups（P 〉 0.05 ）, and the difference in the level of serum IFN-γ, was not significant among the three groups, too （ P 〉 0.05 ）. The immunohistochemisty staining showed high expression of IFN-γ in the inflammation biopsies with Hp infection （ P 〈 0.05 ） ; and the expression of IL-4 was high in the gastric cancer biopsies with I-Ip infection（P 〈 0.05 ）. Conclusions：Local Th1/Th2 cellular immune response has correlation with the progression of pathological changes in patients with Hp infection, especially in patients with gastric cancer.