不同胃黏膜病变中COX-2与NF-κB p65蛋白表达及其相互关系研究

目的:观察NF-κB p65、COX-2在胃黏膜病变胃黏膜中的表达,探讨其表达与胃癌发生、发展的关系。方法:用免疫组化方法测定胃黏膜病变病例中COX-2、NF-κB p65蛋白的表达。结果:CAG、IM、DYS、GC的COX-2表达率分别为33.3%、36.6%、57.5%、72.5%,与CSG(10%)相比差异有显著性。CAG、IM、DYS、GC的NF-κB p65表达率分别为26.7%、33.3%、55.0%、62.5%,与CSG(0.03%)相比差异有显著性。相关性分析显示,胃癌组织中NF-κB p65和COX-2表达呈明显正相关。结论:COX-2和NF-κB p65参与了胃癌的形成过程,COX-2和NF-κB p65的检测可能为胃癌的早期诊断及临床判断预后提供依据。     

Study on the pathological basis of classification of spleen deficiency in chronic gastritis

Background Spleen in Traditional Chinese Medicine (TCM) is not actually the spleen in the anatomic sense designated in western medicine because its functions basically belong to the physiological category of digestive system in modern medicine, and it represents a macroscopic concept of digestion, absorption and nutrition metabolism. Spleen deficiency syndrome refers to the clinical phenomena such as hypofunction of digestion, absorption and nutrition metabolism. By integrating TCM with modern medicine, this paper is intended to explore the pathological basis of classification of spleen deficiency in chronic gastritis.Method By means of optical microscope, scanning electron microscope (SEM), transmission electron microscope (TEM) and histochemical staining, we conducted histopathological and subcellular ultrastructural (nuclei and mitochondrial) analysis of gastric mucosa of 188 patients of spleen deficiency, and that of 42 voluntary blood donors without clinical symptoms. Results The gastric mucosa of patients with spleen Qi deficiency (SQD) and spleen yang deficiency (SyangD) could either be affected by organic lesion (type G-occurring on the basis of chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG)) or unaffected (type F-chiefly belonging to functional indigestion); spleen yin deficiency (SyinD) and spleen deficiency with Qi stagnation (SDQS) both occurred on the basis of CSG and CAG; and the degree of mucosa inflammatory cells infiltration, the degree of decrease in glands propria, and the incidence of IMⅡb in CSG and CAG were more serious than those of G-SQD and G-SyangD, P<0.05-0.01.Conclusion Spleen deficiency syndrome is likely to occur on the basis of organic lesion of gastric mucosa (disease with symptoms of both CSG or CAG and spleen deficiency symptoms), as well as on the basis of inorganic lesion of gastric mucosa (nondisease with symptoms, which is, despite spleen deficiency symptoms, there is no CSG or CAG). Besides, the clinical phenomenon of disease without symptoms (despite CSG or CAG, there is no spleen deficiency symptoms) occurres because of such factors as genetic diathesis and compensation. The lesion degree of CSG or CAG and the incidence of IMⅡb of SyinD and SDQS are more serious than those CSG and CAG of G- SQD and G- SyangD.     

胃癌及癌前病变中COX-2和NF-κBp65蛋白表达及其相关性研究

目的观察幽门螺杆菌(Hp)、NF-κBp65、COX-2在胃黏膜癌变过程中的表达,探讨其表达与胃癌发生、发展的关系。方法用免疫组化方法测定病例中COX-2、NF-κBp65蛋白的表达,用亚甲兰染色检测Hp。结果①慢性萎缩性胃炎(CAG)、肠上皮化生(IM)、不典型增生(DYS)的Hp感染率与慢性浅表性胃炎(CSG)相比差异有显著性(χ2=6.94,χ2=6.71,χ2=10.60,P<0.01)。胃癌(GC)的Hp感染率与CSG相比差异无显著性(χ2=1.37,P>0.05)。②CAG、IM、DYS的COX-2表达率与CSG相比差异有显著性(χ2=4.81,χ2=5.96,χ2=16.57,P<0.05)。GC的COX-2表达率与CSG相比差异亦有显著性(χ2=34.50,P<0.01)。③CAG、IM、DYS的NF-kBp65表达率与CSG相比差异有显著性(χ2=4.71,χ2=9.02,χ2=20.74,P<0.05)。GC的NF-kBp65表达率与CSG相比差异亦有显著性(χ2=30.71,P<0.01)。结论 Hp感染诱导COX-2和NF-kB表达发生在胃癌形成的早期阶段。COX-2和NF-kBp65参与了胃癌的发生发展过程,这些可能为胃癌的早期诊断及临床判断预后提供理论依据。     

Study on the pathophysiologic basis of classification of ‘spleen’ deficiency in chronic gastritis

Background Most of the studies on traditional Chinese medicine (TCM) ‘spleen’ deficiency syndrome in the recent 30 years were conducted only on the basis of single functional index, neglecting the study on the pathophysiologic internal relationship between spleen deficiency syndrome and gastric diseases in modern medicine. But it was at the subcellular molecular biological level that we explored the pathophysiologic basis of classification of spleen deficiency in chronic gastritis by detecting the bioactive substances in gastric mucosa nuclei and mitochondria. Methods By means of optical microscope, scanning electron microscope (SEM), transmission electron microscopy (TEM) and histochemical staining, we conducted histopathological, subcellular ultrastructural analysis and nuclei and mitochondrial ultrastructural analysis of gastric mucosa of 188 spleen deficiency patients and of 42 voluntary blood donors. At the same time, bioactive substances were measured by means of X-ray energy dispersive analysis system (EDAX) image analysis system, radioimmunoassay method and chemiluminescence method. Results The content of cAMP, superoxide dismutase (SOD), Zn and Cu in gastric mucosa, and the content of Zn and Cu in mitochondria decreased progressively in order of groups: healthy control (HC), spleen Qi deficiency without organic lesion (F-SQD), spleen Yang deficiency without organic lesion (F-SyangD), disease without symptoms group, spleen Qi deficiency with organic lesion (G-SQD), spleen Yang deficiency with organic lesion (G-SyangD), spleen Yin deficiency (SyinD) and spleen deficiency with Qi stagnation (SDQS), chronic spleen deficiency gastritis (CSG) and chronic atrophic gastritis (CAG); decreased in order of HC, intestinal metaplasia (IM)Ⅰa, IMⅠb, IMⅡa and IMⅡb, P&lt;0.05. The content of DNA, Zn and Cu in nuclei progressively increased in order mentioned above, P&lt;0.05.Conclusions The quantitative changes of gastric mucosal cAMP, SOD, Zn, Cu, of mitochondrial Zn, Cu and of nuclear DNA, Zn and Cu are not only the substance base on which the lesion of gastric mucosa tissue structure occurs, but also the substance base on which spleen deficiency is classified. G-SQD and G-SyangD were more likely to be found in low-grade or middle-grade CSG and CAG, while SyinD and SDQS in middle-grade or high-grade CSG, CAG and IMⅡb.     

幽门螺杆菌感染及核转录因子-κBp65表达与胃癌的关系

目的探讨胃黏膜幽门螺杆菌(Helicobactor pylori,Hpylori)感染、核转录因子-κBp65(NF-κBp65)表达与胃癌发生、发展的关系。方法胃癌(GC)标本80例,非典型增生(Dys)40例,萎缩性胃炎(CAG)30例,肠上皮化生(IM)30例,浅表性胃炎(CSG)30例,应用免疫组化方法测定NF-κBp65蛋白的表达,用亚甲兰染色检测Hpylori。结果 CSG、GC中Hpylori阳性和阴性病例NF-κBp65表达差异无显着性(P>0.05),但在CAG、IM、Dys的Hpylori阳性病例中NF-κBp65表达显著高于Hpylori阴性病例(42.1%vs 7.7%、67.9%vs 18.2%、78.6%vs 25.0%)。结论Hpylori感染诱导NF-κBp65表达发生在胃癌形成的早期阶段。     

Intestinal metaplasia,dysplasia and gastric cancer:a study of mucohistochemistry,immunohistochemistry and cell DNA quantitative analysis

One hundred and sixty-eight specimens of intestinal metaplasia(IM)with variousaccompanying lesions in gastric mucosa were studied with mucohistochemical and ABCimmunohistochemical staining,The quantitative analysis of cell DNA was done withflowcytometry for 36 specimens.The results indicated that the incidence of type Ⅱb IM wassignificantly higher in the groups of dysplasia(34.6％)and mucosa adjacent to gastric cancer(GC)(51.7％)than in the chronic atrophic gastritis(CAG)group(16.0％)(P<0.01).The expres-sion rate of monoclonal antibody MG7 related antigen(MG7-Ag)in type Ⅱb IM(473％)wasalso significantly higher than those in type la(29.7％),Ib(26.1％)and Ⅱa IM(28.3％)(P<0.05).Expression rate of MG7-Ag,DNA aneuploid rate and percentage of S phase cell werestatistically higher in the type Ⅱb IM with dysphsia(62.5％,62.5％ and 143±32)than in typeⅡb 1M without dysplasia(47.3％,12.5％and12.7±2.9)(P<0.05 and P<0.01).These findingssuppor the supposed progressive process:CAG→type Ⅱb IM→dysplasia→GC,andtype Ⅱb IM with dysplasia is closely associated with GC.     

EGFR基因在不同胃黏膜中表达的研究

目的:研究胃癌(gastric cancer,GC)及不同胃黏膜组织中表皮生长受体(EGFR)的表达规律及其与凋亡的关系,探讨胃癌形成过程中的可能机制,为临床应用以表皮生长受体靶点的胃癌防治措施提供理论依据。方法:采用免疫组织化学染色(SP法)检测不同胃黏膜组织中EGFR。30例浅表性胃炎(chronic super-ficial gastritis,CSG);31例萎缩性胃炎(chronic Atrophic gastritis,CAG),15例异型增生(Dysplasia,Dys),胃癌组织32例。结果:从CSG→CAG→Dys→GC过程中,EGFR表达均呈递增趋势。CSG灰度值(57.64±4.44)、CAG灰度值(55.05±6.97)、Dys灰度值(48.59±4.16);GC灰度值(32.25±4.13)。EGFR表达在CSG、CAG、Dys、GC之间表达有统计学意义(P<0.05)。胃癌组织EGFR的表达与年龄、性别、肿瘤大小无关;在临床分期和组织分化程度方面EGFR阳性表达率明显不同,具有统计学意义(P<0.05)。结论:EGFR基因表达可作为在胃黏膜由浅表向萎缩、不典型增生和胃癌发展过程中的有用指标,且EGFR基因表达可判断胃癌的组织类型,分化程度。     

胃癌及癌前病变中Survivin和 COX-2蛋白的表达及其与Hp感染的关系

[目的]分析胃癌及癌前病变survivin、COX-2蛋白表达与幽门螺杆菌(Helicobacter pylori,Hpylori)感染的关系,探讨胃癌发病的可能机制。[方法]收集胃癌标本51例,非癌胃黏膜标本47例,应用快速尿素酶试验与W-S银染色法将各种病变分为Hp感染阳性组和阴性组,应用免疫组化SP法对各种病变survivin、COX-2蛋白的表达进行检测。采用χ2检验进行数据分析。[结果]Survivin蛋白的表达从慢性浅表性胃炎(CSG)到胃癌(GC)逐渐增加,其中慢性萎缩性胃炎(CAG)组明显低于肠化生(IM)、不典型增生(Dys)和胃癌(GC)组(Survivin 30.5%vs60.0%、62.5%、70.6%,P<0.05),而IM、Dys组与GC组差异无显著性意义(P>0.05);COX-2蛋白在CSG、CAG、IM、Dys、GC中的表达率分别为0%、23.1%、60.0%、50.0%、68.6%。其中,CAG组亦明显低于IM、Dys、GC组(P<0.05),而IM、Dys组与GC组差异无显著性意义(P>0.05)。在GC组,Hp阳性者Survivin、COX-2表达明显高于Hp阴性者(S...     

胃黏膜肠化及胃癌中三叶因子1,2表达的组织芯片技术研究

目的:三叶因子1(trefoil factor 1,TFF1)和2(TFF2)对胃肠道黏膜保护和损伤后修复具有重要作用,在胃癌中表达降低.现探讨它们在胃黏膜肠化(intestinal metaplasia,IM)及不同组织类型胃癌发生中的作用.方法:胃癌40例,癌旁组织IM 32例,慢性萎缩性胃炎(chronic atrophic gastritis,CAG)伴IM 46例,CAG和慢性浅表性胃炎(chronic superficial gastritis,CSG)各20例,构建组织芯片.分别用高铁二铵/爱先蓝(HID/AB)及HE染色对IM及胃癌进行分型,并用免疫组化检测不同胃黏膜病变中TFFl,TFF2的表达.结果:TFFl,TFF2在不同胃黏膜病变中的表达有显著性差异(P＜0.01),CSG,CAG中的表达显著高于CAG伴IM、癌旁组织IM及胃癌(P＜0.01),而CSG与CAG之间,以及CAG伴IM、癌旁组织IM及胃癌三者之间比较均无显著性差异(P＞0.05).肠型胃癌则显著低于弥漫型胃癌(P＜0.05).结论:胃黏膜IM及胃癌中TFF1,TFF2表达显著降低.     

A COMPARATIVE STUDY OF DNA FLOW CYTOMETRY AND MICROSPECTROPHOTOMETRY IN GASTRIC CARCINOMAS

Flow cytometric (FCM) and microspectrophotometric (MSP) measurements of cell nuclear DNA content were made in 53 fresh gastric carcinoma specimens and in 30 gastric mucosal specimens with chronic gastritis. DNA aneuploidy was found in 32/53 (60%) of gastric carcinomas, and appeared more frequently in wellor moderately differentiated tubular adenocarcinomas (90%) than in undifferentiated and mucousa cell carcinomas (23.6%) (P<0.001). No aneuploidy was found in chronic gastritis samples, but their proliferative cell fractions were higher than in normal control gastric mucosa samples (P<0.01). A comparison was made between FCM and MSP analyses of DNA content in 29 cases of gastric carcinoma, a high correlation rate (r=0.90) was found. The advantages and limitations of both methods are discussed, they may be used in combination for more precise cytochemical analysis.