【作者】 杨霞；

【导师】 李国华；

【作者基本信息】 南昌大学 ， 消化内科， 2009， 硕士

【摘要】 目的:观察胃癌组织中HMGI/Y和Jun B的表达情况,探讨其在胃癌发生发展中的可能作用及其相互关系。方法:收集2008年1月至2008年5月在南昌大学第一附属医院胃镜室行胃镜检查的患者胃粘膜标本共126例。其中男90例,女36例,年龄20～88岁,平均年龄53.6岁。每例患者在内镜下至少用活检钳取2块组织行病理及免疫组织化学检查。胃镜活检病理提示正常胃粘膜组织20例(A组),肠上皮化生15例(B组),上皮内瘤变16例(C组,其中8例取自我院病理科存档蜡块),胃癌组织75例(D组)。胃癌中高中分化31例,低分化44例;胃窦胃角癌共31例,胃体胃底贲门癌共44例;肿瘤面积小于3.0cm者25例,大于3.0cm者50例;患者年龄小于30岁者6例,30-60岁者44例,大于60岁者25例;男性患者52例,女性患者23例。75例胃癌患者住院手术治疗共49例,术后病理示病变限于黏膜下层23例(其中19例取自我院病理科存档蜡块),病变侵及肌层26例;有淋巴结转移27例,无淋巴结转移22例;TNM分期I、II期者共25例,III-VI期者共24例。应用免疫组化方法检测各组HMGI/Y和Jun B的表达情况,分析各组织中HMGI/Y和Jun B的表达率、表达强度,并分析其表达强度与胃癌临床病理特征之间的关系及其相关性。结果:①HMGI/Y在正常胃粘膜、肠上皮化生、上皮内瘤变组织及胃癌组织中表达阳性率分别为25%、60 %、75%、88.0%,随着黏膜组织越趋近于恶性组织,其HMGI/Y阳性表达率逐渐升高(P<0.05)。而且癌组织中HMGI/Y表达强度明显高于其它组织(P<0.05);上皮内瘤变组织表达强度显著高于正常胃粘膜组织(P<0.05)。但肠上皮化生、上皮内瘤变两组之间,肠上皮化生与正常胃粘膜两组之间表达强度均无显著性差异(P>0.05)。在病变浸润肌层、有淋巴结转移、临床分期III-IV期的患者,其癌组织中HMGI/Y的表达强度分别显著强于癌未浸润肌层、无淋巴结转移、临床分期I-II期的患者(P<0.05)。但不同分化程度、不同病变部位、不同病灶大小、不同年龄组及不同性别之间,其癌组织中HMGI/Y的表达强度均无显著性差异(P>0.05)。②Jun B在正常胃粘膜、肠上皮化生、上皮内瘤变组织及胃癌组织中表达阳性率分别为95%、93.3%、87.5%、74.7%,随着黏膜组织恶性程度的增加,Jun B的表达率逐渐下降,但无显著性差异((P>0.05),如将肠上皮化生、上皮内瘤变组织作为癌前病变进行统计,正常胃粘膜、癌前病变、胃癌组织中表达阳性率有显著性差异(P<0.05)。而且胃癌组织中Jun B表达强度明显低于正常胃粘膜及肠上皮化生组织(P<0.05),但与上皮内瘤变组织表达强度之间无显著性差异(P>0.05);上皮内瘤变组织中Jun B表达强度明显低于正常胃黏膜组织(P<0.05),但与肠上皮化生组织表达强度差异无统计学意义(P>0.05)。肠上皮化生组织中Jun B表达强度也与正常胃黏膜组织无显著性差异(P>0.05)。在病变浸润肌层、有淋巴结转移、临床分期III-IV期的患者,其癌组织中Jun B的表达强度分别明显弱于癌未浸润肌层、无淋巴结转移、临床分期I-II期的患者(P<0.05)。但不同分化程度、不同病变部位、不同病灶大小、不同年龄组及不同性别之间,其癌组织中JunB的表达强度均无显著性差异(P>0.05)。③胃癌组织中HMGI/Y和JunB的表达强度之间呈负相关(P<0.05)。结论:HMGI/Y在胃癌组织中表达上调,且与胃癌的临床分期、淋巴结转移及肿瘤的浸润深度呈正相关;而Jun B与此相反。且HMGI/Y和Jun B在胃癌中的的表达强度呈负相关。提示HMGI/Y和Jun B在胃癌发生发展中可能起重要作用。更多还原

【Abstract】 Objective:To observe the expressions of HMGI/Y and Jun-B proteins in gastric carcinoma, and to evaluate their possible effect in cancerogenesis and development of gastric carcinoma.Methods:126 patients enrolled into our study, which come from our hospital from the January 2008 to May 2008, received endoscopy, and diagnosed by gastric tissue pathology. There were 20 cases with normal gastric mucosa, 15 cases with intestinal metaplasia, 16 cases with intraepithelial neoplasia(8 of them were taken from pathology department of our hospital),, and 75 cases with gastric cancer. There were 31 cases with well-moderately differentiated, 44 cases with poorly differentiated in 75 cases with gastric cancer. The 31 gastric cancer located in antrum or gastric angle, 44 gastric cancer located in fundus, cardia or gastric body. The size of 25 gastric cancer was less than 3.0cm, but that of 50 more than 3.0cm. There were 6 cases less than 30 years old, 44 cases between from 30 to 60 years old, 25 cases more than 60 years old in 75 patients with gastric cancer (52 male, 23 female). 49 of 75 cases with gastric cancer accepted surgical treatment in our hospital. Cancer tissue of 23 cases limited in mucosa or submucosa(19 of them were taken from pathology department of our hospital), and cancer tissue of 26 cases infiltrated muscular layer after operation. 27 cases accepted operation had lymph node metastasis, 22 no lymph node metastasis. 25 cases accepted operation were staged in TNM I to II period, 24 cases in TNM III to VI period. The expressions of HMGI/Y and Jun-B in all gastric tissues were detected by immunohistochemistry method. The relationship between the expression of HMGI/Y and Jun-B with clinic pathological features was analyzed.Results:①The positive expression rates of HMGI/Y in normal gastric mucosa, intestinal metaplasia, intraepithelial neoplasia and gastric cancer tissues were 25%, 60 %, 75%, and 88.0% respectively. The more malignant the gastric tissue was, the higher the positive expression rate of HMGI/Y was (P<0.05). The expression intensity of HMGI/Y in gastric cancer was higher than other kinds of tissues (P<0.05), and that in intraepithelial neoplasia was higher than normal gastric tissues (P<0.05), but there was no significant difference between intestinal metaplasia and intraepithelial neoplasia, or between intestinal metaplasia and normal gastric tissues (P>0.05). The HMGI/Y expression intensity in patients with tumor infiltrating muscular layer, having lymph node metastasis, or staged in TNM III to IV period, was significant higher than that with tumor limiting in mucosa and submucosa, having no lymph node metastasis, or staging in TNM I to II period respectively (P<0.05). However, the HMGI/Y expression intensity had no significant difference in different differentiation degree,different cancer region, different tumor sizes, different age, or different sex (P> 0.05).②The positive expression rates of Jun B in normal gastric mucosa, intestinal metaplasia, intraepithelial neoplasia and gastric cancer tissues were 95%, 93.3%, 87.5%, and 74.7% respectively. The more malignant the gastric tissue was, the lower the positive expression rate of Jun B was. There was significance among positive expression rates of normal gastric mucosa, precancerous tissues, and cancer tissues (P<0.05).The expression intensity of Jun B in gastric cancer was lower than in noaml gastric tissues and intestinal metaplasia tissues (P<0.05), and that in intraepithelial neoplasia was lower than normal gastric tissues (P<0.05), but there was no significant difference between intestinal metaplasia and intraepithelial neoplasia, or between intraepithelial neoplasia and cancer tissues (P>0.05). The Jun B expression intensity in pateins with tumor infiltrating muscular layer, having lymph node metastasis, or staging in TNM III to IV period, was significant lower than that with tumor limiting in mucosa and submucosa, having no lymph node metastasis, or staging in TNM I to II period respectively (P<0.05). However, the Jun B expression intensity had no significant difference in the different differentiation degree,different cancer region, different tumor sizes, different age, or different sex (P>0.05).③There was a negatively correlated between the expression of HMGI/Y and Jun-B in gastric carcinoma (P<0.05).Conclusions: HMGI/Y expression upregulated in intraepithelial neoplasia and gastric carcinoma, and its expression intensity was positive correlated with clinical stage, lymph node metastasis and infiltrating depth of gastric carcinoma, while Jun B was opposite. There was negatively correlated between HMGI / Y and Jun B expression. HMGI/Y and Jun B may play an important role in cancerogenesis and development of gastric carcinoma.更多还原