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目的:研究幽门螺杆菌(Hp)感染的胃癌及癌前病变患者胃粘膜p53、bcl-2、c-myc基因的表达,以探讨Hp在胃癌发生、发展过程中的作用机制。方法:应用免疫组化方法测定60例胃癌组织、18例异型增生、29例肠上皮化生、35例萎缩性胃炎、29例浅表性胃炎组织中bcl-2、c-myc基因蛋白表达情况,PCR/SSCP测定p53基因第5～8外显子突变,Hp阳性由快速尿素酶法和HE染色确定。结果:胃癌组Hp阳性41例,阴性19例。在胃癌组织中p53、bcl-2、c-myc基因阳性表达分别为38例(63.3%)、38例(63.3%)、18例(30.0%)。p53、c-myc基因在胃癌中阳性表达率显著高于异型增生(P<0.05)。bcl-2在异型增生组织中的阳性表达率与胃癌、肠上皮化生相比无显著性差异(P>0.05)。p53、bcl-2、c-myc基因表达与胃癌分期、淋巴结转移均无显著性关系(P>0.05),但bcl-2与胃癌类型、分化程度显著相关(P<0.05)。每一种病变类型Hp阳性组p53、bcl-2、c-myc基因蛋白的阳性表达率均高于Hp阴性组,两者之间有显著性差异(P<0.05)。结论:Hp感染者具有更多肿瘤生物学行为,可以引起抑癌基因p53第5～8外显子突变,癌基因c-myc、凋亡调节基因bcl-2表达增加,Hp可能为促癌剂,在胃癌的发生发展中起一定作用。
Objective: To study the expression of p53, bcl-2 and c-myc in gastric mucosa of gastric cancer and precancerous lesions infected with Helicobacter pylori (Hp) in order to investigate the mechanism of Hp in the occurrence and development of gastric cancer. Methods: The expressions of bcl-2 and c-myc in 60 cases of gastric cancer, 18 cases of dysplasia, 29 cases of intestinal metaplasia, 35 cases of atrophic gastritis and 29 cases of superficial gastritis were detected by immunohistochemistry The mutation of exon 5 ~ 8 of p53 gene was detected by PCR / SSCP. Hp positive was determined by rapid urease and HE staining. Results: Hp positive in gastric cancer group 41 cases, negative 19 cases. The positive expression rates of p53, bcl-2 and c-myc in gastric cancer tissues were 38 (63.3%), 38 (63.3%) and 18 (30.0%) respectively. The positive rates of p53 and c-myc in gastric cancer were significantly higher than those in dysplasia (P <0.05). The positive rate of bcl-2 in dysplasia tissues was not significantly different from that in gastric cancer and intestinal metaplasia (P> 0.05). The expression of p53, bcl-2 and c-myc had no significant correlation with gastric cancer staging and lymph node metastasis (P> 0.05), but the correlation between bcl-2 and gastric cancer type and differentiation was significant (P <0.05). The positive rates of p53, bcl-2 and c-myc in Hp positive group were higher than those in Hp negative group (P <0.05). CONCLUSIONS: Hp-infected patients have more tumor biological behaviors and may cause mutation of exon 5-8 of oncogene p53, increase of c-myc oncogene and bcl-2 expression of apoptosis-regulating gene, and Hp may be a tumor promoting agent , Plays a role in the occurrence and development of gastric cancer.