胃粘膜肠上皮化生CST-Л的表达及其与H.pylori相关性研究

Expression of л glutathioe S-transferase in intestinal metaplasia and its relationship with H.pylori infection

目的探讨GST-在胃癌发生过程中表达,及在肠化阶段以GST-为代表的人体对致癌物解毒系统与H.pylori致毒作用间的相互作用。方法利用S-P法对219例胃粘膜活检标本进行GST-单克隆抗体的检测:利用HID-AbpH2.5-PAS粘蛋白组化学技术对171例肠化粘膜进行分型;利用HE及H.pylori-DNA PCR及ELISA方法对正常胃粘膜和肠化粘膜进行H.pylori的检测。对80例H.pylori阳性患者进行H.pylori根除治疗三个月后进行H.pylori、GST-的检测。结果正常胃粘膜未见GST-的表达,肠化粘膜GST-阳性率为69.6％,胃癌GST-阳性率为44.4％,高于正常胃粘膜(P<0.01),低于肠化粘膜(P<0.05).H.pylori阴性组SGT-阳性率高于H.pylori阳性组(P<0.05)。H.pylori根除治疗后,根除组GST-表达高于未根除组(P<0.05)。结论正常胃粘膜→肠化粘膜→胃癌组织GST-表达由无→高→低,GST-弱阳性或阴性的Ⅲ型肠化与胃癌关系密切:肠化粘膜中GST-弱阳性或阴性表达如合并H.pylori感染者,胃癌发生的危险性增加,提示在肠化阶段H.pylofi的致毒作用与机体对致癌物的解毒作用彼此相互拮抗。

Object To study dynamic changing of GST- in mormal gastric mucous, intestinal metaplasia (IM), and gastric cancer,to investigate the relationship between human carcinogen detoxification system and the virulence of H.pylori in the stage of IM. Methods Detecting the expression of GST- in 30cases with normal gastric mucosa;171 cases with IM,18cases with gastric cancer by S-P immunohistochemical method.The types of IM are classified by high-iron diamine/alcian blue pH2.5/periodic acid-Schiff(HID-ABpH 2.5-PAS)method.H.pylori infection was confirmed or excluded in all patients by histological examination hematoxylin-eosin(HE),urease of H.pylori -DNA PCRand enzyme-linked immunosorbent assay(ELISA).80 cases with H.pylori infection were received H.pylori eradication. Results The positive rates of GST- expression in IM and gastric cancer were significantly higher than that of normal gastric mucosa, which was all negative(P<0.01).The positive rates of GST- expression of gastric cancer is lower than that of IM(P<0.01).The positive rates of GST- expression in Ⅰ subtype IM, Ⅱ subtype IM, Ⅲ subtype IM were decreased in sequence(83.3%,71.1%,48.9%).The positive rate of GST- expression in H.pylori-negative positive groups IM were higher than H.pylori-positive groups IM(P<0.05);After the H.pylori was eradicated,the positive rate of GST- expression in H.pylori-eradicated group was significantly higher than that of H.pylori-positive group before the H.Pylori was eradicated(P<0.01).The positive rate of GST- expression in H.pylorieradicatived group was significantly higher than gastric cancer group(P<0.01).Conclusions From normal gastric mucous,IM to gastric cancer, the expression rate of GST- is from no expression.to high,and to low again.From Ⅰ—Ⅱ—Ⅲ IM,the expression rate of GST is from high to low.We conclude that Ⅲ type IM has a high risk of developing gastric cancer if it has low or no expression of GST- Our findings demonstrated that the risk of developing gastric cancer be increased if there was the low or no expression of GST- in Hpylori infectioned patienst.as well as demonstrated that the human carciongen destoxification system and the virulence of H.pylori might interact with each other in IM.