腺口形态的变化与胃癌发生的关系

Relations between changes of pit pattern presentations and occurrences of gastric cancer

关键词:  早期胃癌  突变型P53蛋白  增殖细胞核抗原（PCNA）  腺口形态

Key words:  primary gastric cancer  proliferating cell nuclear antigen(PCNA)  P53 protein  pit pattern

摘要:

［目的］探讨胃黏膜腺口形态在胃癌多阶段发生过程中各阶段的变化规律。［方法］用免疫组织化学SP染色方法检测早期胃癌手术标本28例共33个病灶的PCNA及抑癌基因蛋白P53的表达情况，并用实体显微镜技术观察胃黏膜腺口形态的变化。［结果］胃黏膜的腺口形态分为Ⅰ、Ⅲs、ⅢL、Ⅳ与Ⅴ型；Ⅰ型的92.6%、ⅢL型的95.7%组织 学上表现为正常组织形态；Ⅲs型、Ⅰ型的7.4%及Ⅳ型的57.1%表现为肠上皮化生；ⅢL型的4.3%、Ⅳ型的38.8%、Ⅴ型的15.2%组织学上表现为异型增生，其PCNA阳性细胞 率分别为23.88%、34.37%和49.21%(P<0.05),Ⅳ型有10.53%、Ⅴ型有60%出现P53阳性表达（P<0.01）；Ⅳ型的4.1%和Ⅴ型的84.8%组织学上表现为癌，其PCNA阳性细胞率分别为41.63%和49.76%(P>0.05)，Ⅴ型有50%出现P53阳性着色。［结论］早期胃癌的基本腺口形态为Ⅳ型与Ⅴ型，在胃癌多阶段发生过程中，腺口形态按一定规律变化，并且伴随基因水平的变化。

Abstract:

［Objective］ To study the regular pit pattern presentation of the developing process of gastric cancer in multi-stage. ［Methods］To examine the percentage of PCNA-positive cells and P53-positive staining ofprimary gastric cancer by immunohistochemistry (SP method) and observe their pit patterns by stereomicroscope (inspected by 33 focuses in 28 cases). ［Results］ Pit patterns of gastric mucosa consist of type Ⅰ, Ⅲs, ⅢL, Ⅳ and Ⅴ, 92.6% of type Ⅰ, 95.7% of type ⅢL are normal tissue; type Ⅲs, 7.4% of type Ⅰ and 57.1% of type Ⅳ are shown as intestinal metatlasia, 4.3% of type ⅢL, 38.8% of type Ⅳ and 15.2% of type Ⅴ are shown as dysplasia, their percentages of PCNA-positive cells are respectively 23.9%, 34.4% and 49.2%(P<0.05), 10.5% of type Ⅳ and 60.0% of type Ⅴ　show P53-positive staining (P<0.01); 4.1%of type Ⅳ and 84.8% of type Ⅴ are shown as cancer ,their percentages of PCNA-positive cells are respectively 41.6% and 49.8%(P>0.05), 50% of type V shows P53 positive-staining. ［Conclusion］The fundamental pit patterns of primary gastric cancer are types of Ⅳ and Ⅴ, The pit patterns are shown some certain regulavity with gene expression in the multisteps of gastric carcinogenesis.