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目的:探讨胃癌及癌前病变组织中环氧化酶-2(COX-2)、p53的表达情况,分析其与幽门螺杆菌(Hp)感染的相关性。方法:选取慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、肠上皮化生(IM)、上皮内瘤变(IN)、胃癌患者各30例,采用免疫组化法检测COX-2、p53的表达,组织学改良Giemsa染色联合快速尿素酶试验(HPUT)检测Hp,分析各病变组COX-2、p53的表达情况及其与Hp感染的关系。结果:各组黏膜组织中COX-2、p53阳性表达率及Hp感染率差异显著(P=0.000),其中胃癌组各指标的阳性率均显著高于其他各组(P<0.05)。Hp感染阳性组织中COX-2、p53阳性表达率分别为80.8%、60.3%,Hp感染阴性组织中COX-2、p53阳性表达率分别为13.9%、15.3%,差异有统计学意义(P<0.01)。Hp感染伴COX-2和/或p53表达阳性均为胃癌发病的危险因素(OR=12.366,25.394,22.516,P<0.05)。结论:Hp感染,COX-2、p53阳性表达等因素的相互作用可能在胃癌发生发展过程中发挥重要作用,临床可对高危人群进行相关指标的联合检测。
Objective: To investigate the expression of cyclooxygenase-2 (COX-2) and p53 in gastric cancer and precancerous lesions, and to analyze the correlation between the expression of COX-2 and p53 in Helicobacter pylori (Hp) infection. Methods: Thirty patients with chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), intestinal metaplasia (IM), intraepithelial neoplasia (IN) and gastric cancer were enrolled in this study. Immunohistochemistry was used to detect the expression of COX- The expression of COX-2 and p53 and the relationship with Hp infection were analyzed by Giemsa stain combined with rapid urease test (HPUT). Results: The positive rate of COX-2 and p53 and the rate of Hp infection in each group were significantly different (P = 0.000). The positive rate of each index in gastric cancer group was significantly higher than that in other groups (P <0.05). The positive rates of COX-2 and p53 in Hp-positive tissues were 80.8% and 60.3% respectively, and the positive rates of COX-2 and p53 in Hp-negative tissues were 13.9% and 15.3%, respectively (P < 0.01). Hp infection with positive expression of COX-2 and / or p53 were risk factors of gastric cancer (OR = 12.366,25.394,22.516, P <0.05). Conclusion: The interaction of Hp infection, COX-2 and p53 expression may play an important role in the development and progression of gastric cancer. Combined detection of related indicators in high-risk population can be clinically performed.