幽门螺杆菌在胃癌及其癌前疾病中的原位检测及意义  

In situ detection of Helicobacter pylori in gastric cancer and precancerous diseases and its significance

作　　者：于秀文[1] 董楠楠[1] 宫月华[1] 徐倩[1] 袁媛[1] 

机构地区：[1]中国医科大学附属第一医院普通外科研究所暨肿瘤研究所第三研究室辽宁省高校肿瘤病因与预防重点实验室,辽宁省沈阳市110001

出　　处：《世界华人消化杂志》2008年第33期3740-3745,共6页World Chinese Journal of Digestology

基　　金：辽宁省高校重点实验室资助项目;No.20060913~~

摘　　要：目的:探讨H pylori感染在胃癌及癌前疾病中的分布状态以及在胃癌的发生及分化中的作用以及免疫组化法检测H pylori感染的价值.方法:随机选取辽宁省庄河地区不同胃疾病胃黏膜活检标本327例,包括慢性浅表性胃炎63例、萎缩性胃炎62例,胃癌202例,常规HE染色及免疫组织化学染色,观察黏膜、黏液H pylori感染密度.结果:不同胃疾病H pylori在胃黏膜定植状态为浅表性胃炎、萎缩性胃炎高于胃癌(χ2=96.998,87.542,均P<0.01),胃癌组织低于癌周黏膜(χ2=5.378,P<0.01),肠型胃癌高于弥漫型胃癌(χ2=19.253,P<0.01).不同胃疾病H pylori在胃黏液游离状态为H pylori密度评分≤2时,浅表性胃炎、萎缩性胃炎低于胃癌(χ2=6.526,6.218,均P<0.01),H pylori密度评分>2时,浅表性胃炎、萎缩性胃炎高于胃癌(χ2=20.252,46.248,均P<0.01),萎缩性胃炎高于浅表性胃炎(χ2=4.746,P<0.05),胃癌与癌周黏膜无统计学差异,肠型胃癌高于弥漫型胃癌(χ2=6.784,P<0.01).结论:不同胃疾病H pylori分布,浅表性胃炎、萎缩性胃炎高于胃癌,胃癌低于癌周黏膜,肠型高于弥漫型.黏液内游离H pylori密度评分胃癌组织与癌周黏膜无差异.免疫组化染色检测H pylori优于HE.AIM：To investigate the distribution of H pylori infection in gastric cancer and precancerous diseases and the role of H pylori infection in the incidence and differentiation of gastric cancer,as well as the clinical value of H pylori infection detection using immunohistochemical method.METHODS：Biopsy specimens of gastric muco-sa in various diseases were randomly selected from 327 cases in Zhuanghe region in Liaoning Province,including 63 cases of superficial gas-tritis,62 cases of atrophic gastritis and 202 cases of gastric cancer.HE staining and immunohis-tochemical staining were used to measure the density of H pylori infection in gastric mucosa and mucus.RESULTS：The H pylori colonization status was higher in superficial gastritis group or in atrophic gastritis than gastric cancer group（χ2 =96.998,87.542,both P〈0.01）,while the status was lower in gastric cancer group than peri-cancer mucosa（χ2=5.378,P〈0.01）,higher in the intestinal gastric cancer group than in dif-fused gastric cancer（χ2=19.253,P〈0.01）.When H pylori density score was≤2,the H pylori free status in superficial gastritis and atrophic gas-tritis were lower than that of gastric cancer（χ2 =6.526,6.218,both P〈0.01）,and when H pylori density score〉2,it was higher in superficial gastritis group or atrophic gastritis group than in gastric cancer group（χ2=20.252,46.248,both P〈0.01）,it was higher in atrophic gastritis than in superficial gastritis（χ2=4.746,P〈0.05）,and it was higher in the intestinal gastric cancer than in diffused gastric cancer（χ2=6.784,P〈0.01）.CONCLUSION：The H pylori distribution is higher in superficial gastritis and atrophic gas-tritis than in gastric cancer,lower in gastric cancer than in peri-cancer mucosa,higher in the intestinal gastric cancer than in diffused one.There is no significant difference in the free H pylori density score between gastric cancer tissue and peri-cancer mucosa.Immunohisto-chemical detection of H pylori is better than HE staining.

关 键 词：幽门螺杆菌 免疫组织化学 原位检测 胃疾病 分布状态 

分 类 号：R735.2[医药卫生—肿瘤] R573.1[医药卫生—临床医学]