【摘要】 目的　研究胃癌及癌前病变幽门螺杆菌 (HP)感染与p2 1和p5 3表达的相互关系 ,以探讨HP感染可能的致癌机制。方法　所有活检标本均经病理组织学明确诊断 ,包括胃癌 42例 ,不典型增生 2 3例 ,肠上皮化生 2 6例 ,慢性萎缩性胃炎 14例 ,慢性浅表性胃炎 2 4例及正常组织 2 0例。应用免疫组化法检测上述标本中p2 1及p5 3的表达 ,以甲苯胺蓝染色法检测HP。结果　不典型增生、肠上皮化生、萎缩性胃炎及浅表性胃炎组织HP的感染率均明显高于正常组织 (P <0 .0 5 ) ;胃癌略高于正常组织 ,其中非贲门部胃癌 (6 1.9% ,13/2 1)明显高于贲门部胃癌 (2 8.6 % ,6 /2 1) (P <0 .0 5 )。p2 1及p5 3在各组织中的阳性表达率分别为 :胃癌 6 6 .7%和 6 4.3%、不典型增生47.8%和 43.5 %、肠上皮化生 30 .8%和 2 3.1%、萎缩性胃炎 2 1.4%和 2 1.4% ,而浅表性胃炎及正常组织均为 0。HP阳性组的p2 1及p5 3的阳性率在胃癌、不典型增生及肠上皮化生组织均明显高于HP阴性组 (P <0 .0 5 )。结论　HP感染与p2 1和p5 3过度表达有明显的相关性 ,提示HP感染可能参与了ras癌基因激活和p5 3基因的突变而引起胃癌更多还原

【Abstract】 Objective To investigate the relationship between Helicobacter pylori (HP) infection and expression of p21 (ras proto-oncogene product p21 protein) and p53 (p53 cancer suppressive gene product mutant p53 protein). Methods The biopsy samples from 42 cases of gastric cancer (GC), 23 dysplasia (Dys), 26 intestinal metaplasia (IM), 14 chronic atrophic gastritis (CAG), 24 chronic superficial gastritis (CSG) and 20 normal gastric mucosa, were examined for the expression of p21 and p53 by immunohistochemical method and for the presence of HP after toluidine blue staining. Results The HP positive rates in Dys, IM, CAG and CSG groups were significantly higher than that in normal gastric mucosa group (P<0.05). In GC patients, the HP positive rate in non-cardiac cancer cases was obviously higher than in cardiac cancer cases (61.9% vs 28.6%, P<0.01). The expressions of p21 and p53 were zero in CSG and normal gastric mucosa groups, significantly higher in GC and Dys groups than in other groups. Besides, the rates of p21 and p53 expression were higher among the HP positive patients than among the HP negative ones in the GC, Dys and IM groups (P<0.05). Conclusion HP infection is significantly related to the expreessions of p21 and p53 , suggesting that HP infection be involved in the activation of ras oncogene and mutation of p53 tumor suppresser gene.更多还原