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目的研究 Hp 根除前后胃黏膜上皮细胞端粒酶 RNA(hTR)及增殖细胞核抗原(PCNA)表达的变化。分析 hTR 与 PCNA 表达的关系。方法对南昌大学第一附属医院1997年至2000年间建立的幽门螺杆菌(Hp)感染慢性胃炎研究人群再次进行胃镜追踪随访,共随访60例,根据 Hp 感染情况分为 Hp 根除组、Hp 未根除组及Hp 持续阴性组三组。分别采用 RNA 原位核酸杂交及免疫组织化学染色方法检测 Hp 根除前后胃黏膜 hTR、PC-NA 的表达。结果治疗前 Hp 阳性者 hTR 阳性率及增殖指数(PI)分别为51.3%、16.8±5.8,均显著高于 Hp 阴性者(19.0%、8.8±3.4,P<0.01)。Hp 根除者治疗后 hTR 阳性率及 PI 均较治疗前显著下降(22.2%对55.5%、7.0±5.0对16.8±5.8,P<0.05),且与 Hp 阴性对照组相比无显著性差异;而 Hp 未根除者及 Hp 持续阴性者治疗前后均无显著性变化。治疗前 hTR 阳性者增殖指数为15.9±6.3,hTR 阴性者为12.6±5.8,两者相比差异有显著性意义(P<0.05)。结论 Hp 感染诱导 hTR 过度表达,促进细胞增殖,且 hTR 激活细胞多处于高增殖状态;及时有效地根除 Hp 可使 hTR 表达下降或消失,纠正细胞异常增殖状态,从而降低胃黏膜癌变的可能性。
Objective To study the changes of telomerase RNA (hTR) and proliferating cell nuclear antigen (PCNA) expression in gastric mucosal epithelial cells before and after Hp eradication. Analysis of the relationship between hTR and PCNA expression. Methods Gastroenteroscopic follow-up was performed on gastroscope patients with Helicobacter pylori (Hp) infection established in the First Affiliated Hospital of Nanchang University from 1997 to 2000. A total of 60 follow-up cases were divided into Hp eradication group and Hp eradication group Group and Hp persistent negative group three groups. The expression of hTR and PC-NA in gastric mucosa before and after Hp eradication were detected by RNA in situ hybridization and immunohistochemical staining respectively. Results The positive rate of hTR and the index of proliferation (PI) of Hp positive patients before treatment were 51.3% and 16.8 ± 5.8, respectively, which were significantly higher than those of Hp negative patients (19.0%, 8.8 ± 3.4, P <0.01). The positive rates of hTR and PI in Hp eradication group were significantly lower than those before Hp eradication treatment (22.2% vs 55.5%, 7.0 ± 5.0 vs 16.8 ± 5.8, P <0.05), and no significant difference compared with Hp negative control group Hp non-eradication and persistent Hp were no significant changes before and after treatment. Proliferation index of hTR positive before treatment was 15.9 ± 6.3, hTR negative was 12.6 ± 5.8, the difference was significant (P <0.05). Conclusion Hp infection can induce hTR over-expression and promote cell proliferation, and hTR-activated cells are mostly in high proliferative state. The timely and effective eradication of Hp can reduce or eliminate the expression of hTR and correct the abnormal proliferation of cells, thereby reducing the possibility of canceration of gastric mucosa.