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为了解胃粘膜癌变过程中多基因蛋白的表达及意义，应用免疫组化技术检测１０７例内镜活检胃粘膜组织中增殖细胞核抗原（ＰＣＮＡ）及ｐ５３、Ｋ－ｒａｓ、ｂｃ１－２基因蛋白。结果各基因蛋白阳性率随病变程度加重而增加。Ⅲ型肠化生者增殖细胞核抗原标记指数（ＰＣＮＡＬＩ）及Ｋ－ｒａｓ、ｂｃ１－２基因蛋白阳性率较之Ⅰ、Ⅱ型肠化亦有增高趋势但未见统计学差异（Ｐ≥０．０５）。１２例Ⅲ型肠化中有９例出现Ｋ－ｒａｓ或ｂｃ１－２蛋白异常表达（７５．０％），显著高于Ⅰ、Ⅱ型肠化（２３．８％）（Ｐ＜０．０５）。在肠型及胃型胃癌ｐ５３表达率为５３．３％、３７．０％（Ｐ＞０．０５）；Ｋ－ｒａｓ为４０．０％、７．４％（Ｐ＜０．０５）；ｂｃ１－２为９３．３％、５９．３％（Ｐ＜０．０５）。１５例肠型胃癌中有９例同时存在２种或２种以上蛋白异常表达（３例ｐ５３与ｂｃ１－２表达异常，２例ｂｃ１－２与Ｋ－ｒａｓ表达异常，４例ｐ５３与ｂｃ１－２、Ｋ－ｒａｓ异常表达），高于胃型胃癌（Ｐ＜０．０５）。结果提示以上基因产物的表达异常与胃粘膜癌变相关，Ⅲ型肠化属于胃癌癌前病变范畴，肠型胃癌发生发展的分子机制与胃型胃癌显著不同。
To investigate the expression and significance of multiple genes in gastric carcinogenesis, immunohistochemistry was used to detect the expression of proliferating cell nuclear antigen (PCNA) and p53, K-ras and bcl-2 proteins in 107 cases of endoscopic biopsies. Results The positive rate of each gene protein increased with the severity of the lesion. The positive rate of PCNALI, K-ras and bc1-2 in type Ⅲ intestinal metaplasia was higher than that in type Ⅰ and type Ⅱ, but there was no statistical difference (P> 0.05 ). Nine cases of type Ⅲ intestinal metaplasia had abnormal expression of K-ras or bc1-2 protein (75.0%), which was significantly higher than that of type Ⅰ and Ⅱ (23.8%) (P <0.05) . The expression rates of p53 in intestinal and gastric gastric carcinomas were 53.3% and 37.0%, respectively (P> 0.05); K-ras was 40.0% and 7.4% (P <0.05) -2 was 93.3%, 59.3% (P <0.05). In 15 cases of intestinal type gastric cancer, there were 9 cases with abnormal expression of 2 or more proteins (3 cases of p53 and bc1-2 expression abnormalities, 2 cases of bc1-2 and K-ras expression abnormalities, 4 cases of p53 and bc1-2 , K-ras abnormal expression), higher than gastric gastric cancer (P <0.05). The results suggest that the abnormal expression of the above gene products is related to the gastric mucosal carcinogenesis. The type Ⅲ intestinal metaplasia belongs to the category of precancerous lesions of gastric cancer. The molecular mechanism of the development and progression of intestinal-type gastric carcinoma is significantly different from that of gastric gastric carcinoma.