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目的 探讨p5 3、bcl 2基因和增殖细胞核抗原 (PCNA)等生物学指标在胃癌前病变不同转归中的作用。 方法 采用免疫组化 (LSAB)法检测 5 2例胃癌患者胃癌及癌前病变组织标本及 5 6例非胃癌患者癌前病变〔胃黏膜中度以上肠上皮化生和 (或 )异型增生〕组织标本的p5 3、bcl 2和PCNA的表达。 结果 (1)在癌前病变中 ,p5 3、bcl 2在癌组与非癌组之间的表达差异无显著性 (P >0 0 5 ) ,PCNA标记指数 (PCNALI)在癌组表达明显高于非癌组 ,差异有显著性 (P <0 0 1) ;(2 )p5 3、bcl 2和PCNA表达在胃癌组织均显著高于癌变前组织 (P <0 0 1) ;(3)在肠型胃癌 ,癌前p5 3、bcl 2阳性者到癌时仍全为阳性 ,无 1例转阴 ;在弥漫型胃癌 ,癌前bcl 2阳性者到癌时有 1例转阴。 结论 在肠型胃癌发生发展过程中 ,p5 3、bcl 2蛋白表达起重要作用 ,且发生癌变前细胞增殖活性已明显升高。
Objective To investigate the role of biological markers such as p53, bcl2 and proliferating cell nuclear antigen (PCNA) in different outcomes of precancerous lesions. Methods Immunohistochemistry (LSAB) method was used to detect tissue samples of gastric cancer and precancerous lesions in 52 patients with gastric cancer and precancerous lesions in 56 patients with non-gastric cancer (stomach and intestinal metaplasia and/or dysplasia). The expression of p53, bcl2 and PCNA in the specimen. Results (1) In precancerous lesions, there was no significant difference in the expression of p53 and bcl2 between the cancer group and the non-cancer group (P > 0.05), and the PCNA index was significantly higher in the cancer group (P> 0.05). In non-cancer group, the difference was significant (P <0 01); (2) p53, bcl-2 and PCNA expression in gastric cancer were significantly higher than in precancerous tissue (P <0 01); (3) in Gastrointestinal gastric cancer, precancerous p53 and bcl-2 positive were all positive at the time of cancer and none of them were negative. In diffuse gastric cancer, precancerous bcl-2 positive patients had cancer in 1 case. Conclusion The expression of p53 and bcl-2 plays an important role in the development of intestinal type gastric cancer, and the cell proliferation activity before canceration has been significantly increased.