萎缩性胃炎伴肠上皮化生浅表隆起灶黏膜中Reg4和Ki67表达高于浅表凹陷灶黏膜  

The expression levels of Reg4 and Ki67 in superficial elevated mucosa lesions of atrophic gastritis with intestinal metaplasia are higher than those in superficial depressed mucosa lesions

作　　者：郁岩杰[1] 赵治国[1] 于泳[1] 任景丽[2] 王宪远[2] 虎建恩[2] 弋晓萍[1] 温静[1] 冯常炜[1] 李振峰[1] 唐芙爱[1] 

机构地区：[1]郑州大学第二临床学院消化内科,郑州450014 [2]郑州大学第二附属医院病理科,郑州450014

出　　处：《肿瘤》2011年第10期937-941,共5页Tumor

摘　　要：目的:检测胃窦处不同形态的肠上皮化生黏膜中再生基因4(regenerating gene4,Reg4)、Ki67表达情况,确认哪种黏膜浅表形态的增殖活性高,推测发生异型增生或癌变的可能性大。方法:分别用免疫组织化学及半定量反转录PCR(reverse transcriptase-PCR,RT-PCR)方法对385例胃镜活检获得的不同病变胃黏膜不同形态标本组织进行Reg4、Ki67因子的蛋白质和mRNA水平检测。结果:非萎缩性胃炎黏膜、萎缩性胃炎黏膜、萎缩性胃炎伴肠化呈浅表凹陷黏膜(简称肠化凹陷灶)、萎缩性胃炎伴肠化呈浅表隆起黏膜(简称肠化隆起灶)和胃癌黏膜组织中Reg4的蛋白表达阳性率分别为12.3%、26.7%、43.6%、93.6%和31.5%,其中肠化隆起灶与非萎缩性胃炎、萎缩性胃炎、肠化凹陷灶、胃癌的表达差异均有统计学意义(P<0.05);以上5种组织中Ki67的蛋白表达阳性率分别为14.8%、18.7%、23.1%、69.2%和71.2%,呈渐进性增高,其中肠化隆起灶与非萎缩性胃炎、萎缩性胃炎、肠化凹陷灶的表达差异也有统计学意义(P<0.05),而与胃癌比较差异无统计学意义(P>0.05)。肠化隆起灶Reg4和Ki67的mRNA水平也高于肠化凹陷灶。结论:肠化隆起灶黏膜中Reg4和Ki67表达水平比肠化凹陷灶黏膜高,推测前者发生异型增生或癌变的可能性大于后者。因此在胃镜活检中,肠化隆起灶黏膜可能是更有价值的活检点。Objective： To infer which morphologic change of gastric mucosa has more probability to develop into dysplasia or cancer by detecting the expressions of regenerating gene 4 （Reg4） and Ki67 in different morphologies of intestinal metaplasia in gastric antrum. Methods： Immunohistochemistry and semiquantitative reverse transcriptase-polymerase chain reaction （RT-PCR） were used to examine the expression levels of Reg4 and Ki67 proteins and mRNAs in mucosal biopsy specimens of 385 cases of different types of gastric disease. Results： In the gastric mucosal biopsy specimens each from nonatrophic gastritis （NAG）, atrophic gastritis （AG）, atrophic gastritis with intestinal metaplasia displaying superficial depressed mucosa lesions （DIM）, atrophic gastritis with intestinal metaplasia displaying superficial elevated mucosa lesions （ELM） and gastric cancer （GC）, the positive rates of Reg4 protein was 12.3%, 26.7%, 43.6%, 93.6% and 31.5%, respectively; the positive rate of Reg4 protein of ElM was significantly different from those of NAG, AG, DIM and GC （P〈0.05）. The positive rates of Ki67 protein were 14.8%, 18.7%, 23.1%, 69.2% and 71.2% in NAG, AG, DIM, ElM and GC, respectively; the positive rate of Ki67 protein in ElM was significantly different from those of NAG, AG and DIM （P〈0.05） but not different from that of GC （P〉0.05）. The expressions of Reg4 and Ki67 mRNAs in ElM were also significantly higher than those in DIM. Conclusion： The expression levels of Reg4 and Ki67 in ElM were higher than those in DIM, which suggests that ElM may have more probability to develop into dysplasia or cancer than DIM, and DIM may become a more valuable specimen for gastric biopsy.

关 键 词：胃炎 萎缩性 癌前病变 内镜检查 肠上皮化生 

分 类 号：R573.3[医药卫生—消化系统] R730.4[医药卫生—内科学]