胃黏膜癌变过程中细胞增殖及c-erbB-2与EGFR表达的研究

Research on cell proliferative activity and expressions of c-erbB-2,EGFR in the process of gastric carcinogenesis

目的 :探讨胃黏膜癌变过程中细胞增殖活性的变化以及增殖细胞核抗原 (proliferatingcellnuclearantigen ,PCNA)、c erbB 2、表皮生长因子受体 (epidermalgrowthfactorreceptor ,EGFR )在胃癌发病过程中的意义。方法 :应用免疫组织化学ABC法检测 11例正常胃黏膜 ,18例肠上皮化生 ,7例轻中度不典型增生 ,9例重度不典型增生 ,5 0例胃癌组织中PCNA、c erbB 2、EGFR的表达情况。结果 :胃黏膜癌变过程中均可见PC NA的阳性表达 ,随病变程度的加重 ,PCNA增殖指数亦逐渐上升 ,各组间差异有统计学意义 ,P <0 0 5 ,但重度不典型增生与胃癌组织相比较 ,PCNA指数差异无统计学意义 ,P >0 0 5。在肠上皮化生、不典型增生及胃癌组织中均有c erbB 2和EGFR蛋白表达 ,其中重度不典型增生与胃癌组织中c erbB 2的阳性表达率明显高于轻中度不典型增生 ,P <0 0 5 ,胃癌组织中的EGFR阳性表达率明显高于肠上皮化生 ,P <0 0 5。结论 :在胃黏膜癌变过程中 ,细胞增殖活性逐渐增高。其中重度不典型增生阶段的细胞增殖活性与胃癌已较为接近 ,提示重度不典型增生具有更大的恶变潜能。c erbB 2和EGFR表达是胃黏膜癌变的早期事件 ,二者可能具有协同作用。

OBJECTIVE:To study the changes of cell proliferative activity and the significance of expressions of PCNA,c erbB 2,EGFR gene in the process of gastric carcinogenesis.MOTHEDS:Expressions of PCNA,c erbB 2,EGFR gene of 95 gastric specmens obtained from clinic patients were measured and analysed by using immunohistochemistry method.RESULTS:Expression of PCNA was measured in all gastric cancinogenesis.The higher the proliferative index was,the worse the gastric mucosa became, P <0 05.However,the difference between severe dysplasia (Dys) and gastric cancer was not significant, P >0 05.c erbB 2 and EGFR protein expressions were detected in intestinal metaplasia(IM),dysplsia and gastric cancer.The positive staining of c erbB 2 in severe Dys and gastric cancer was higher than that in mild/moderate Dys, P <0 05.The positive staining of EGFR in gastric cancer was higher than that in severe Dys, P <0 05.CONCLUSIONS:The cell proliferative activity increases gradually in the process of gastric cancinogenesis.The cell proliferative activity in severe Dys is close to gastirc cancer during this process,suggesting that the severe Dys has a more malignancy change potential.Expressions of c erbB 2,EGFR gene are the early event in gastric cancinogenesis.The enhancement of c erbB 2 activity seems to be cooperated with EGFR activation in the gastric cancer development.