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目的:研究胃癌组织中磷蛋白53(P53)、磷蛋白21野生型p53活化片段(p21WAF1)蛋白的表达及与幽门螺杆菌L型(Hp-L)感染的关系。方法:选择我院2013年1月至2017年1月病理确诊为胃癌的标本220例为胃癌组,另外选取胃癌组织旁的健康组织为对照组。Hp-L采用快速尿素酶测试法、Giemsa染色法检测,P53、p21WAF1阳性表达采用HE法及免疫组化法测定,并采用Spearman等级检验分析其相关性。结果:胃癌组p53阳性表达率显著高于对照组(P<0.05);p21WAF1阳性表达率显著低于对照组(P<0.05),胃癌组织中p53和p21WAF1表达呈负相关(P<0.05)。胃癌组Hp-L阳性感染率显著高于对照组(P<0.05);胃癌组Hp-L阳性组p53阳性表达率显著高于于阴性组(P<0.05);p21WAF1阳性表达率显著低于阴性组(P<0.05),胃癌组织中p53与Hp-L阳性表达呈正相关(P<0.05),p21WAF1与Hp-L阳性表达呈负相关(P<0.05),p53阳性表达仅与浸润程度有关(P<0.05),P21WAF1表达与病理分级、浸润程度、UICC分期有关(P<0.05)。结论:Hp-L是胃癌发生的主要诱因,癌症发展过程中,Hp-L型感染可上调p53表达、抑制p21WAF1表达,且p53、p21WAF1的表达变化与细胞浸润程度有密切联系,对胃癌的临床治疗具有重要作用。
OBJECTIVE: To study the relationship between the expression of p21WAF1 protein and the H.pylori L-form infection in gastric cancer tissues. Methods: Totally 220 gastric cancer specimens were selected from January 2013 to January 2017 in our hospital for pathological diagnosis. The healthy tissues adjacent to gastric cancer tissues were selected as the control group. Hp-L by rapid urease test, Giemsa staining, P53, p21WAF1 positive expression by HE method and immunohistochemistry, and Spearman rank test to analyze the correlation. Results: The positive rate of p53 in gastric cancer was significantly higher than that in control (P <0.05). The positive rate of p21WAF1 was significantly lower than that of control (P <0.05). The expression of p53 and p21WAF1 in gastric cancer was negatively correlated (P <0.05). The positive rate of Hp-L in gastric cancer group was significantly higher than that in control group (P <0.05). The positive rate of p53 in Hp-L positive gastric cancer group was significantly higher than that in negative group (P <0.05); the positive rate of p21WAF1 was significantly lower than that in negative group (P <0.05). There was a positive correlation between p53 and Hp-L expression in gastric cancer (P <0.05), negative correlation between p21WAF1 and Hp-L expression (P <0.05) P <0.05). The expression of P21WAF1 was correlated with pathological grade, infiltration degree and UICC stage (P <0.05). Hp-L infection can up-regulate the expression of p53 and inhibit the expression of p21WAF1, and the expression of p53 and p21WAF1 is closely related to the degree of cell infiltration. In the clinical development of gastric cancer Treatment has an important role.