p27蛋白及PCNA在慢性胃病及胃癌患者胃黏膜中的表达及临床意义

Expression and clinical significance of p27 and PCNA protein in patients with chronic gastric diseases and in patients with gastric cancer

目的研究慢性胃病及胃癌患者胃黏膜中p27蛋白及PCNA的表达水平,探讨p27蛋白及PCNA的表达与胃癌演变的关系。方法选择消化科门诊胃镜检查患者黏膜活检标本共计155例,其中慢性非萎缩性胃炎32例、慢性萎缩性胃炎25例、肠上皮化生30例、非典型增生32例、胃癌36例。采用免疫组织化学SP法检测慢性非萎缩性胃炎、慢性萎缩性胃炎、肠上皮化生、非典型增生及胃癌组患者胃黏膜中p27蛋白与PCNA的表达水平并进行临床分析。结果 P27蛋白在胃癌组织浅表部位着色相对较强,而深部着色较弱,PCNA在胃癌组织的边缘区多余中央区,深层多于浅层。随着慢性非萎缩性胃炎、慢性萎缩性胃炎、肠上皮化生、非典型增生、胃癌的演变规律,P27蛋白表达水平呈现逐级减低,PCNA表达水平呈现逐级升高,两两组间比较差异均有统计学意义(P<0.05)。胃黏膜P27蛋白表达水平与非萎缩性胃炎、慢性萎缩性胃炎、肠上皮化生、非典型增生、胃癌疾病类型呈负相关(r=-0.976,P<0.01),PCNA表达水平与上述疾病类型呈正相关(r=0.979,P<0.05),5组间胃黏膜P27蛋白与PCNA表达水平呈负相关(r=-0.920,P<0.01)。P27蛋白和PCNA表达水平均与年龄、性别、肿瘤部位、大小无相关性(P>0.05)。结论 P27蛋白及PCNA在胃黏膜中的表达水平与慢性胃病、胃癌前病变、胃癌的发生发展有关,其在胃癌的演变过程中起着重要的作用。

Objective To observe the expression levels of p27 and PCNA protein in patients with chronic gastric diseases and in patients with gastric cancer,and to explore the correlation between the expressions of p27,PCNA protein and pathogenesis of gastric cancer. Methods A total of 155 biopsy specimens of gastric mucous membrane by gastroscopy were collected including 32 cases of chronic non-atrophic gastritis,25 cases of chronic atrophic gastritis,30 cases of intestinal metaplasia,32 cases of atypical hyperplasia and 36 cases of gastric carcinoma. The expression levels of p27 and PCNA protein in gastric mucosa were detected by immunohistochemistry（ SP） and statistically analyzed. Results The colouring of P27 protein in gastric cancer tissue superficial parts was relatively strong,however,which in deep part was relatively weak. The expression levels of p27 were gradually decreased in the order of chronic non-atrophic gastritis,chronic atrophic gastritis,intestinal memplasia,atypical hyperplasia and gastric carcinoma,however,the expression levels of PCNA were gradually increased with the order,there were significant differences between two groups each other（ P〈0. 05）. Moreover the expression levels of P27 were negatively correlated with chronic non-atrophic gastritis,chronic atrophic gastritis,intestinal memplasia,atypical hyperplasia and gastric carcinoma,（ r =-0. 976,P〈0. 01）,however,the expression levels of PCNA were positively correlated with the disease types mentioned above（ r = 0. 979,P〈0. 05）. In addition the the expression levels of P27 were negatively correlated with those of PCNA among the 5 groups（ r =-0. 920,P〈0. 01）. Moreover the expressio nlevels of P27 and PCNA protein were not correlated with patient＇s age and sex,location and size of tumor（ P〈0. 05）. Conclusion The expression levels of P27 and PCNA protein in gastric mucosa are correlated with the pathogenesis and development of chronic gastric diseases,gastric precancerous lesion and gastric cancer,which play an important role during the development process of gastric cancer.