胃黏膜TGF-β1在幽门螺杆菌感染中的表达及与外周血T细胞亚群变化的关系  

Association of TGF-β1 expression in gastric mucosa with Helicobacter pylori infection and changes in peripheral blood T lymphocyte subsets during gastric carcinogenesis

作　　者：李红平[1] 赵逵[1] 毛万姮[2] 方宁[3] 刘华庆[4] 张锚链[4] 

机构地区：[1]遵义医学院附属医院消化内科,贵州省遵义市563003 [2]遵义医学院附属医院康复医学科,贵州省遵义市563003 [3]遵义医学院附属医院细胞工程重点实验室,贵州省遵义市563003 [4]遵义医学院附属医院病理科,贵州省遵义市563003

出　　处：《世界华人消化杂志》2010年第5期506-511,共6页World Chinese Journal of Digestology

基　　金：贵州省遵义医学院青年基金资助项目;No.院(2006)023~~

摘　　要：目的:探讨幽门螺杆菌(H.pylori)感染、TGF-β1及T淋巴细胞亚群在胃黏膜癌变过程中的作用及相互关系.方法:选取不同胃黏膜病变组织的72例胃镜活检标本,采用快速尿素酶试验(rapid urease test,RUT)结合Giemsa染色判断H.pylori感染,免疫组织化学染色技术检测胃黏膜组织中TGF-β1表达,流式细胞术检测不同胃黏膜病变患者外周血T淋巴细胞亚群CD3+、CD4+、CD8+及CD4+/CD8+比值.结果:TGF-β1在慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、肠上皮化生及不典型增生(IM/Dy)和胃癌(GC)中表达的阳性率分别为39.1%,52.6%,62.3%和87.5%,CSG组与IM/Dy、GC组相比,差异有统计学意义(P<0.05);IM/Dy中H.pylori阳性者TGF-β1表达明显高于H.pylori阴性者(87.5%vs33.3%,P<0.05).与CSG相比,GC中CD3+明显降低(P<0.05),CD4+及CD4+/CD8+明显降低(P<0.01);IM/Dy患者CD4+及CD4+/CD8+低于CSG,有显著性差异(均P<0.01).不同胃黏膜病变TGF-β1表达与CD3+、CD4+T细胞、CD4+/CD8+呈负相关.结论:在GC前病变中,从CSG到GC,TGF-β1表达逐渐增加,细胞免疫功能降低,TGF-β1对细胞免疫功能的抑制作用是IM/Dy、GC患者细胞免疫功能低下的原因之一.AIM：To investigate the association of transforming growth factor-beta 1 （TGF-β1） expression in gastric mucosa with Helicobacter pylori （H.pylori） infection and changes in peripheral blood T lymphocyte subsets in patients with gastric precancerous lesions at different stages.METHODS：Seventy-two gastric mucosa specimens were taken gastroscopically from patients with gastric precancerous lesions at different stages.H.pylori infection was evaluated by rapid urease test （RUT） in combination with Giemsa staining.The expression of TGF-β1 in gastric mucosa was detected by immunohistochemistry.The T lymphocyte subsets in peripheral blood were measured by flow cytometry.RESULTS：The positive rates of TGF-β1 expression in chronic superficial gastritis （CSG）,chronic atrophic gastritis （CAG）,intestinal metaplasia and atypical dysplasia （IM/Dy）,and gastric carcinoma （GC） were 39.1%,52.6%,62.3% and 87.5%,respectively.The positive rate of TGF-β1 expression in CSG was significantly lower than that in IM/Dy （P 0.05）.In patients with IM/Dy,the positive rate of TGF-β1 expression in H.pylori-positive patients was higher than that in H.pylori-negative ones （P 0.05）.The percentages of CD3 ＋,CD4 ＋ and CD4 ＋ /CD8 ＋ T lymphocytes were significantly lower in patients with GC than in patients with CSG （all P 0.05 or 0.01）.The percentages of CD4 ＋ and CD4 ＋ /CD8 ＋ T lymphocytes in patients with IM/Dy were lower than those in patients with CSG （both P 0.01）.The positive rate of TGF-β1 expression was negatively correlated with the percentages of CD3 ＋,CD4 and CD4 ＋ /CD8 ＋ T lymphocytes in patients with gastric precancerous lesions.CONCLUSION：The expression of TGF-β1 gradually increases and cellular immune function is gradually weakened during the evolution from CSG to GC.The suppressive effects of TGF-β1 on cellular immune function can partly explain why patients with IM/Dy have lower cellular immune function.

关 键 词：幽门螺杆菌 转化生长因子-Β1 T淋巴细胞亚群 流式细胞术 癌前病变 胃癌 

分 类 号：R573[医药卫生—消化系统]