【摘要】 目的 :观察胃癌组织中自发性癌细胞凋亡及癌基因MDM2、病理组织学类型、浸润深度、淋巴结癌转移对肠型胃癌和胃型胃癌自发性癌细胞凋亡的影响。方法 :应用脱氧核糖核酸末端转移酶介导的dUTP缺口末端标记(TUNEL)技术显示凋亡细胞 ,免疫组化SABC法显示MDM2 ,组织化学Mowry阿尔辛蓝过碘酸雪夫 (ABPAS)染色法显示胃癌组织中的中性和酸性粘液。结果 :4 8例胃癌平均凋亡指数为 8.6 0± 2 .6 0 ,其中 30例肠型胃癌平均凋亡指数为 6 .80± 1.6 7,显著高于 18例胃型胃癌 (3.6 0± 2 .6 0 ) ;30例肠型胃癌MDM2阴性者自发性凋亡指数为 7.5 0± 1.6 2 ,明显高于MDM2阳性者 (5 .80± 1.14 ) ;18例胃型胃癌MDM2阴性者自发性凋亡指数为 7.2 0± 1.10 ,亦明显高于MDM2阳性者 (2 .2 0± 1.36 ) ,胃型胃癌MDM2的阳性率高于肠型胃癌 (χ2 =4 .6 8,P <0 .0 5 )。无论是肠型胃癌还是胃型胃癌 ,累及与未累及浆膜的癌细胞凋亡指数差异无显著性 (分别为t=0 .5 2 ,P >0 .0 5 ;t=1.70 ,P >0 .0 5 ) ;5种组织学类型间癌细胞凋亡指数的比较 ,差异均无显著性 (分别为F =1.90 ,P >0 .0 5 ,F =2 .2 3,P >0 .0 5 )。肠型胃癌有或无淋巴结转移组癌细胞凋亡指数无明显差异 (t =0 .2 6 ,P >0 .0 5 ) ;而胃型胃癌有或无淋巴结转移组癌细胞凋?更多还原

【Abstract】 Objective: To observe the spontaneous apoptosis in gastric type and intestinal type of gastric carcinoma and the impact of oncogene MDM2 and histogic types and different infiltration deep and having lymph node metastasis or not on them. Methods: Terminal deoxynucleotidyl transfer mediated nick end labeling (TUNEL) technique and immunohistochemisty and AB PAS histochemisty were used to display apoptosis cell, MDM2 and neutral or acid mucins. Results: Apoptosis index (AI) of total forty eight cases was 8.60±2.60 on average,of which the AI of thirty intestinal type cases was 6.80±1.67 on average. It was obviously higher than that of the eighteen gastric type cases, which was 3.60± 2.60 ,t=4.64,P<0.01. The spontaneous AI of thirty intestinal type of gastric circinoma negative MDM2 was 7.50± 1.62 , obviously higher than that of the positive, which was 5.80±1.38,t=3.48,P<0.01. The spontaneous AI of eighteen gastric type of negative cases was also obviously higher than that of the positive. The former was 7.20±1.91,and the latter was 2.20±1.36,t=3.48,P<0.01. The positive ratio of gastric type MDM2 was higher than that of intestinal type(χ 2=4.68,P<0.05). No matter whether intestinal type or gastric type, the AI of serosa with cancerous cells infiltration had no difference. They were t=0.52,P>0.05;t=1.70,P>0.05. There were also no obvious difference between ratio of serosa with cancerous cells infiltration or not of the two type(χ 2=1.42,P>0.05). The comparison of the AI among the five histologic types(papillary adenocarcinom; glandular adenocarcinom; mucoid adenocarcinom; Signet ring cell carcinoma; undifferentiation carcinoma) that had no obvious difference. They were F=1.90,P>0.05,F=2.23,P> 0.05 .Lymph node metastasis had no impact on the AI of intestinal type; It was t=0.26,P>0.05; gastric type was impacted on it, t=5.87,P<0.01. The lymph node metastasis ratio of the two gastric cancerous types was very different (χ 2=4.48,P<0.05). Polyatomic logistic regression analysized that with various factors considered, only the AI has numerous impact on two gastric cancerous types(χ 2=9.64,P<0.01). Conclusion: The spontaneous AI of gastric type gastric carcinoma is obviously lower than that of intestinal type. The AI of two types is impacted by the expression of MDM2 and can decided whether there is lymph node metastasis or not. It has no obvious connection with the infiltration deep and histologic types.更多还原