胃癌中幽门螺杆菌感染与癌基因蛋白表达及凋亡

The research between Helicobacter pylori and expression of oncogene and apoptosis in gastric carcinoma

目的 研究幽门螺杆菌 (Hp)感染的胃癌 (GC)发展过程中c met蛋白表达与细胞凋亡的关系及对胃癌预后的意义。方法 对 14 5例经病理证实的不同胃粘膜病变采用免疫组化法检测c met基因表达及Warthin starry法检测Hp感染。采用原位末端标记法 (TUNEL)检测细胞凋亡。结果 在浅表性胃炎 (CSG)、萎缩肠化生胃炎 (CAG +IM )、异型增生 (DYS)、早期GC和进展期GC中 ,c met基因表达率分别为 2 5 .5 3 %、5 1.2 8%、6 1.5 4%、6 6 .6 7%和 6 8.42 % ,CAG +IM、DYS、GC的c met基因表达率均显著高于CSG (P <0 .0 5 )。凋亡指数 (AI)分别为( 4 .5 5± 2 .33) %、( 6 .43± 5 .6 0 ) %、( 6 .45± 5 .12 ) %、( 6 .5 5± 4.80 ) %和 ( 8.84± 5 .6 3) % ,进展期GC显著高于CSG(P <0 .0 5 )。胃粘膜凋亡指数与c met表达强度密切相关 (P <0 .0 5 )。c met阳性表达与胃癌组织类型、浆膜浸润和淋巴结转移密切相关 ,而且BorrmannⅣ明显高于早期胃癌和BorrmannⅠ ,Ⅱ (P <0 .0 5 )。Hp阳性者 5年生存期显著短于Hp阴性者。 结论 Hp感染和c met表达与胃粘膜增殖和恶化有关 ,且与凋亡有相关性。Hp感染与胃癌预后有关。

Objective To determine whether there is a relationship between Helicobacter pylori (Hp) infection and expression of c-met oncogene and apoptosis in gastric mucosal lesions, and its prognostic significance of gastric carcinomas (GC).Methods Expression of c-met was investigated in 145 specimens of gastric mucosal lesions by using immunohistochemistry, and Hp was examined by Warthin-starry method. TUNEL method was used to detect apoptosis. Survival analysis was performed with the long rank test for statistical analysis.Results For chronic superficial gastritis(CSG), chronic atrophic gastritis and intestinal metaplasia(CAG+IM), dysplasia (DYS), early GC and advanced GC, the expression rates of c-met were 25.53%, 51.28%, 61.54%, 66.67% and 68.42%,The positive rates were higher in CAG+IM, DYS and GC than that in CSG (P<0.05). Apoptotic indices (AI) were: (4.55±2.33)%?(6.43±5.60)%?(6.45±5.12)%?(6.55± 4.80)%?(8.84±5.63)%,AI was higher in advanced GC than that in CSG(P<0.05). Expression of c-met increased with AI in rank correlation test, they had a close relationship(P<0.01). Expression of c-met was correlated significantly with histologic type, serosal invasion and lymph node metastasis. In particular, the expression of c-met was significantly higher in Borrmann Ⅳ GC than that in early GC or Borrmann Ⅰ,Ⅱ (P<0.01). The prognosis of patients with Hp infection was significantly poorer than that of patients without Hp infection.Conclusions Hp infection and expression of c-met may be associated with apoptosis and malignant transformation of gastric mucosa. Hp infection is associated with prognosis of gastric carcinoma.