胃癌及癌前病变hTERT的表达与细胞免疫功能  

hTERT expression and cellular immunity in gastric cancer and precancerosis

作　　者：姚希贤[1] 尹雷[1] 张杰英[2] 白文元[1] 李英敏[3] 孙中成[4] 

机构地区：[1]河北医科大学第二医院消化内科,河北省石家庄市050000 [2]河北医科大学第二医院病理科,河北省石家庄市050000 [3]河北医科大学病理教研室,河北省石家庄市050017 [4]河北医科大学中医学院,河北省石家庄市050091

出　　处：《世界华人消化杂志》2001年第5期508-512,共5页World Chinese Journal of Digestology

基　　金：河北省卫生厅科研基金;No.2K007

摘　　要：目的观察在胃癌及癌前病变组织中端粒酶催化亚单位hTERT的表达与患者细胞免疫功能,探讨hTERT及细胞免疫功能对胃癌诊断、治疗、预后的临床意义。方法用原位杂交方法对116例内镜胃粘膜活检标本的端粒酶催化亚单位hTERT、进行检测,包括慢性浅表性胃炎(CSG)30例,慢性萎缩性胃炎(CAG)27例、腺瘤型息肉8例、胃溃疡9例,胃癌(GC)42例,并按肿瘤部位、大体类型、有无淋巴结转移及分化程度分组,同时,用流式细胞技术(FCM)检测了30例慢性浅表性胃炎、27例慢性萎缩性胃炎、42例胃癌的外周血T淋巴细胞亚群及自然杀伤(NK)细胞,并与正常对照(NC)相比较。结果 CSG的hTERT阳性率为0％(0/30),癌前病变为36％(13/44),GC为86％(36/42)。胃癌组织hTERT阳性率与肿瘤部位、大体类型、有无淋巴结转移及分化程度无显著可关性,CSG组CD3^+,CD4^+较NC已有明显下降(P<0.05),CAG组T细胞功能(CD3^+,CD4^+,CD4^+/CD8^+)及NK各值较NC及CSG组均明显降低(P<0.05～0.01),GC组T细胞及NK细胞各值较CAG组显著异常(P<0.05-0.01),并随着胃癌进展,CD3^+,CD4^+,CD4^+/CD8^+各值进一步降低。结论端粒酶活化可能是胃粘膜癌变的关键步骤,胃粘膜活检标本hTERT的表达是胃癌癌变过程中重要的生物学标志物,胃癌和癌前病变患者细胞免疫功能低下,对胃癌的发生发展有重要意义。AIM To observe the expression of human telomerase reverse transcriptase (hTERT) in gastric carcinomas and precancerous lesions, evaluate the immune state of such patients, and to study the clinical implications of hTERT and immune state for the diagnosis, treatment and prognosis of gastric cancer. METHODS In situ hybridization was used to detect the expression of hTERT mRNA in 116 endoscopic biopsies of gastric mucosa. Tissue samples were analyzed as follows:30 cases of chronic superficial gastritis (CSG), 44 of precancerous lesions (including 27 of chronic atrophy gastritis, 8 of hyperplastic ploy and 9 of gastric ulcer) and 42 of gastric cancer (GC). At mean time, the Tlymphocyte subsets (CD3^+, CD4^+, CD8^+, CD4^+ /CD8^+) and natural killer cell (NK) in peripheral blood were determined by flow cytometrical analysis (FCM) in 30 cases of CSG, 27 of precancerosis (chronic atrophy gastritis, CAG), 42 of GC and the data were campared with those of normal controls (NC). RESULTS The positive rate of hTERT varied as follows: 0%(0/30) in CSG, 36% (16/44) in precancerous lesions and 86% (36/42)in GC. The expression of hTERT mRNA was not associated with patient's gender, tumor location, macroscopic type, lymph node metastasis and degree of differentiation. The CD3^+ and CD4^+ of CSG were lower than that of NC (P<0.05). Meanwhile, the T lymphocyte subsets (CD3^+, CD4^+, CD4^+/ CD8^+ ratio) were remarkably lower than that of NC and CSG (P<0.05-0.01. Values of T cells and NK cells of GC group were abnormal significantly as compared with CAG (P<0.05-0.01). Furthermore, with the tumor progression, the function of T cells was weakened gradually. CONCLUSION The expression of telomerase may be a crucial step in gastric carcinogenesis and increased hTERT mRNA may serve as a novel marker for diagnosis of gastric cancer. The immune state of patients with gastric cancer and precancerosis was somewhat depressed, which indicates the importance of cellular immunity in cancer patients.

关 键 词：胃肿瘤 免疫学 癌前状态 端粒 末端转移酶 病理 

分 类 号：R735.2[医药卫生—肿瘤]