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目的探讨胃粘膜病变中幽门螺杆菌（Ｈｐ）感染与增殖细胞核抗原（ＰＣＮＡ）及ｒａｓ癌基因表达产物ｐ２１蛋白和突变型ｐ５３蛋白表达的关系。方法采用链霉菌抗生物素蛋白－过氧化酶（ＳＰ）免疫组织化学染色方法及粘膜尿素酶试验、粘膜涂片染色检测３０例慢性浅表性胃炎（ＣＳＧ）、２５例胃粘膜不全结肠型肠化生（ＩＣＭ）、２９例异型增生、３７例胃腺癌活检标本。结果ＩＣＭ组、异型增生组和胃腺癌组的Ｈｐ感染率明显高于ＣＳＧ组，ＰＣＮＡ指数在ＩＣＭ、异型增生及胃癌明显高于ＣＳＧ，差异均有显著性。ＩＣＭ及异型增生与胃癌比较差异也有非常显著性。ｒａｓｐ２１及ｐ５３蛋白阳性表达率在ＣＳＧ为０，在ＩＣＭ及异型增生组的表达率明显低于胃癌组。其中胃癌、异型增生及ＩＣＭ组中 Ｈｐ阳性组的 ＰＣＮＡ指数、ｒａｓｐ２１及 ｐ５３蛋白阳性表达率明显高于 Ｈｐ阴性组，差异均有显著性。经根除Ｈｐ治疗后，ＰＣＮＡ指数在ＩＣＭ及异型增生组中根除Ｈｐ组较未根除组明显下降。ｒａｓｐ２１及ｐ５３蛋白阳性表达阴转率在Ｈｐ根除组较未根除组高。结论Ｈｐ感染可使胃粘膜处于高增殖状态，并可能通过ｒａｓｐ癌基因的激活和ｐ５３抑癌基因的突变而致癌。根除Ｈｐ治疗可能干预这一进程。
Objective To investigate the relationship between Helicobacter pylori (Hp) infection and proliferating cell nuclear antigen (PCNA) and the expression of oncogene p21 protein and mutant p53 protein in gastric mucosal lesions. Methods Streptomyces avidin - peroxidase (SP) immunohistochemical staining and mucosal urease test were used to detect 30 cases of chronic superficial gastritis (CSG) and 25 cases of gastric mucosal insufficiency Metaplasia (ICM), 29 cases of dysplasia, 37 cases of gastric adenocarcinoma biopsy specimens. Results The prevalence of Hp infection in ICM group, atypical hyperplasia group and gastric adenocarcinoma group was significantly higher than that in CSG group. The PCNA index was significantly higher in ICM, dysplasia and gastric cancer than that in CSG. The difference was significant. ICM and dysplasia and gastric cancer are also very significant differences. The positive rate of rasp21 and p53 protein in CSG was 0, which was significantly lower in ICM and dysplasia than in gastric cancer. Among them, the positive rates of PCNA, rasp21 and p53 in gastric cancer, dysplasia and Hp positive group in ICM group were significantly higher than those in Hp negative group, the difference was significant. After eradication of Hp treatment, PCNA index in ICM and dysplasia group eradication Hp group was significantly lower than the non-eradication group. The positive rate of negative expression of rasp21 and p53 protein in Hp eradication group was higher than that of non-eradication group. Conclusion Hp infection can cause gastric mucosa hyperplasia and may cause cancer through the activation of rasp oncogene and the mutation of p53 tumor suppressor gene. Eradication of Hp may interfere with this process.