不同级别胃黏膜上皮瘤变组织幽门螺杆菌感染和趋化因子CXCL12及受体CXCR4表达的关系及意义

Different grades of gastric mucosa epithelial neoplasia tissues of Helicobacter priori infection and the relationship between chemokine CXCL12 and its receptor CXCR4 expression and significance

目的探讨不同级别胃黏膜上皮瘤变组织幽门螺杆菌（Hp）感染和趋化因子CXCL12及其受体CXCR4表达的关系及意义。方法行胃镜活检患者138例，其中正常胃黏膜（NGM）32例，低级别上皮内瘤变（LGIEN）35例，高级别上皮内瘤变（HGIEN）36例，胃腺癌（GCA）35例。Hp感染判定采用^13C呼气试验及血清Hp抗体检测，均阳性判定为Hp感染；CXCL12和CXCR4检测采用免疫组织化学SABC法。结果LGIEN、HGIEN和GCA组织CXCL12和CXCR4阳性表达率均高于NGM组织[71．43％（25／35）、86．11％（31／36）、91．43％（32／35）比25．00％（8／32），71．43％（25／35）、86．11％（31／36）、91．43％（32／35）比28．12％（9／32）]，HGIEN和GCA组织CXCLl2和CXCR4阳性表达率高于LGIEN组织，差异有统计学意义（P〈0．05）；HGIEN和GCA组织CXCL12和CXCR4阳性率比较差异无统计学意义（P〉0．05）。Hp感染与CXCL12和CXCR4阳性表达无相关性（P〉0．05）。结论LGIEN、HGIEN和GCA组织CXCL12和CXCR4阳性表达率均高于NGM组织，HGIEN和GCA组织CXCL12和CXCR4阳性表达率显著高于LGIEN，而HGIEN和GCA组织CXCL12和CXCR4阳性表达率相近。胃黏膜上皮瘤变组织Hp感染与CXCL12和CXCR4阳性表达无相关性，提示Hp感染可能不是通过CXCL12和CXCR4的表达而起到致癌作用的。

Objective To study the effect of different grades of gastric mucosa epithelial neoplasia tissues of Helicobacter pylori （Hp） infection and the relationship between chemokine CXCL12 and its receptor CXCR4 expression and significance. Methods Based on a total of 138 cases of endoscopic specimens, there were normal gastric mucosa （NGM） in 32 eases, low grade intraepithelial neoplasia （LGIEN） in 35 cases, high grade intraepithelial neoplasia （HGIEN） in 36 cases, and gastric adenocareinoma （GCA） in 35 cases. Hp infection was determined by J3C breath test and serum Hp antibodies,the double positive for Hp infection. CXCL12 and its receptor CXCR4 were detected by immunohistochemical method. Results The positive rates of CXCL12 and CXCR4 in LGIEN,HGIEN and GCA were higher than those in NGM： 71.43% （25/35）, 86.11%（31/36）, 91.43%（32/35） vs. 25.00%（8/32）; 71.43%（25/35）, 86.11%（31/36）, 91.43%（32/35）vs. 28.12%（9/32）, P 〈 0.05; the positive rates of CXCL12 and CXCR4 in HGIEN and GCA were higher than those in LGIEN （P 〈 0.05）; the positive rates of CXCL12 and CXCR4 in HGIEN and GCA had no significant difference （P 〉 0.05）. The positive expression of CXCL12 and CXCR4 had no correlation with Hp infection （P 〉 0.05）. Conclusions The positive rates of CXCL12 and CXCR4 in LGIEN,HGIEN and GCA are higher than those in NGM.The positive rates of CXCL12 and CXCR4 in HGIEN and GCA are higher than those in LGIEN. The positive rates of CXCL12 and CXCR4 in HGIEN and GCA are similar. The positive expression of CXCL12 and CXCR4 have no correlation with Hp infection, it suggests that Hp infection may not play oncogenic role by CXCL12 and CXCR4 receptor expression.