慢性萎缩性胃炎内镜表现与病理诊断胃癌前病变的相关性  

Correlation between endoscopic manifestations of chronic atrophic gastritis and pathological diagnosis of gastric precancerous lesions

作　　者：胡筠 陈扬[1] 陈宗华 罗咏萍[1] 刘毅[1] HU Jun;CHEN Yang;CHEN Zonghua;LUO Yongping;LIU Yi(Department of Gastroenterology,the Second People’s Hospital of Yibin,Yibin,644000,China)

机构地区：[1]宜宾市第二人民医院消化科,四川宜宾644000

出　　处：《中国中西医结合消化杂志》2021年第11期804-808,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：四川省卫生健康科研课题普及项目(No:19PJ301)。

摘　　要：目的:探讨慢性萎缩性胃炎内镜表现与病理诊断胃癌前病变的相关性。方法:选取2018年5月—2020年5月接受胃镜检查的患者组织样本,其中胃癌60例,高级别上皮内瘤变60例,低级别上皮内瘤变60例,慢性萎缩性胃炎伴肠上皮化生60例,慢性萎缩性胃炎60例,检测各组组织样本中ARID1A、E-钙黏蛋白(E-cadherin)以及EphA2的表达情况及相关性。结果:胃癌、高级别上皮内瘤变、低级别上皮内瘤变、慢性萎缩性胃炎伴肠上皮化生以及慢性非萎缩性胃炎组织中ARID1A、E-cadherin、EphA2表达组间差异有统计意义(P<0.05),且ARID1A、E-cadherin表达逐级递减,EphA2表达逐级递增;在胃癌、高级别上皮内瘤变、低级别上皮内瘤变、慢性萎缩性胃炎伴肠上皮化生以及慢性非萎缩性胃炎组织中,ARID1A与E-cadherin的表达呈正相关(P<0.05)性,EphA2与E-cadherin、ARID1A的表达均呈负相关性(P<0.05)。结论:胃癌患者存在ARID1A、E-cadherin表达明显降低的情况,而EphA2表达逐级递增,且其表达可互相影响,其中ARID1A可直接影响EphA2、E-cadherin的表达,可将ARID1A作为胃癌治疗的新靶点。Objective:To investigate the correlation between the endoscopic manifestations of elderly chronic atrophic gastritis and pathological diagnosis of gastric precancerous lesions.Methods:From May 2018 to May 2020,tissue samples of elderly patients underwent gastroscopy in our hospital were selected,including 60 cases of gastric cancer,60 cases of high-grade intraepithelial neoplasia,60 cases of low-grade intraepithelial neoplasia,and chronic atrophic gastritis with intestine 60 cases of chronic atrophic gastritis,60 cases of chronic atrophic gastritis,the expression and correlation of ARID1 A,E-cadherin and EphA2 in each group of tissue samples were detected.Results:The differences in the expression of ARID1 A,E-cadherin and EphA2 in gastric cancer,high-grade intraepithelial neoplasia,low-grade intraepithelial neoplasia,chronic atrophic gastritis with intestinal metaplasia,and chronic non-atrophic gastritis were statistically significant(P<0.05),and the expression of ARID1 A and E-cadherin gradually decreases,and the expression of EphA2 gradually increases;In gastric cancer,high-grade intraepithelial neoplasia,low-grade intraepithelial neoplasia,chronic atrophic gastritis with intestinal metaplasia,and chronic non-atrophic gastritis tissue among them,ARID1 A was positively correlated with E-cadherin,and EphA2 was negatively correlated with E-cadherin and ARID1 A.Conclusion:The expressions of ARID1 A and E-cadher in in elderly patients with gastric cancer are significantly reduced,while the expression of EphA2 gradually increases and the expressions can affect each other.ARID1 A can directly affect the expression of EphA2 and E-cadherin.It is believed that ARID1 A can be used as a new treatment for gastric cancer target.

关 键 词：E-钙黏蛋白 胃癌 慢性萎缩性胃炎 胃癌前病变 人ARID1A基因 

分 类 号：R247.9[医药卫生—中医临床基础]