胃黏膜癌变过程中p53表达变化和幽门螺杆菌感染情况

Putative role of p53 expression and Hp infection in gastric carcinogenesis

目的探讨p53表达和幽门螺旋杆菌(H.pylori,Hp)感染在慢性胃炎、胃黏膜异型增生及胃癌中的变化,分析两者的相关性及其在胃癌发生的可能关系。方法采用链霉菌抗生物素蛋白—过氧化物酶连接法(SP)免疫组化法检测p53蛋白在胃黏膜慢性炎症(40例)、胃黏膜异型增生(59例)和胃腺癌(68例)组织中的表达。采用亚甲蓝染色检测上述标本中Hp感染。分析P53表达与Hp感染的相关关系及其在胃癌发生发展中的可能意义。结果 p53在慢性炎症组中偶见个别细胞呈阳性表达(2/40,5.0%),异型增生组和胃腺癌组中p53阳性表达率分别28.8%(17/59)和51.5%(35/68),从慢性炎症组、胃黏膜异型增生到胃腺癌,呈逐渐增高趋势;Hp在慢性炎症组中的检出率为32.5%(13/40),在异型增生组和胃腺癌组中检出率分别为72.9%(43/59)和58.8%(40/68),均明显高于慢性炎症组(P<0.05)。在异型增生组和胃腺癌组,p53阳性表达率在Hp感染阳性组明显高于Hp阴性组,p53阳性表达与Hp感染均呈正相关(r=0.304、0.383,均P<0.05)。结论胃黏膜异型增生和胃腺癌组织p53表达与Hp感染密切相关,p53和Hp在胃腺癌的发生中可能发挥重要作用。

Objective To investigate p53 expression and Helicobacter pylori（H.pylori,Hp）infection in chronic gastritis,gastric dysplasia and gastric carcinoma,and to evaluate their relationship and possible role in gastric carcinogenesis.Methods The expression of p53 in the chronic gastritis（40cases）,dysplasia（59cases）,and gastric adenocarcinoma（68cases）were detected with streptavidin-perosidase（SP）immunohistochemical staining.Hp infection was determined with methylene blue staining.The correlation between p53 expression and Hp infection,and its possible significance in the gastric carcinogenesis were analyzed.Results The results showed that positive p53 expression was occasionally seen in individual cells in chronic gastritis（2/40,5.0%）,and the positive expression rates of p53 in the dysplasia and gastric adenocarcinomas were 28.8%（17/59）and 51.5%（35/68）respectively.The expression of p53 increased from chronic gastritis,gastric dysplasia to gastric carcinoma.Hp was detected in 32.5% of chronic gastritis cases,while the detection rates reached 72.9%（43/59）and 58.8%（40/68）in dysplasia and gastric carcinoma cases,which were all significantly higher than those in chronic gastritis（P〈0.05）.The p53 expression in Hp positive cases was significantly higher than that in Hp negative cases and there were positive correlations between p53 expression and Hp infection in gastric dysplasia and carcinoma cases（r=0.304、0.383,both P〈0.05）.Conclusion Positive p53 expression and Hp infection exsisted in gastric dysplasia and carcinoma cases.P53 and Hp may play important roles in gastric carcinogenesis.