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目的 介绍差异竞争性多聚酶链反应（ｄｉｆｆｅｒｅｎｔｉａｌｌｙ ｃｏｍｐｅｔｉｔｉｖｅ ＰＣＲ，ＤＣ－ＰＣＲ），并分析癌基因 ＨＥＲ２和Ｃ－ｍｙｃ变异与胃癌生物学行为的关系。方法用ＤＣ－ＰＣＲ定量检测胃原发癌、癌旁、转移淋巴结及远处脏器转移癌中ＨＥＲ２和Ｃ－ｍｙｃ扩增。结果 ＨＥＲ２扩增频率在近端胃癌组中高于远端胃癌组（分别是８４．６％和２６．３％，Ｐ＜０．０５），侵及浆膜组明显高于未侵及浆膜组（６６．７％和２８．６％，Ｐ＜０．００５）。Ⅳ期胃癌与Ｉ、Ⅱ期胃癌组间ＨＥＲ２扩增值有显著性差异（Ｐ＜０．０５）。Ｃ－ｍｙｃ在胃癌原发灶及转移淋巴结中的扩增频率分别是１８．８％和２３．８％，２例远处脏器转移癌中有扩增。结论ＨＥＲ２和Ｃ－ｍｙｃ扩增与胃癌进展有关。近、远端胃癌可能有不同的遗传学途径。ＤＣ－ＰＣＲ是一项敏感可靠的基因定量技术。
Objective To introduce differentially competitive polymerase chain reaction (DC-PCR) and analyze the relationship between the oncogene HER2 and C-myc mutations and the biological behavior of gastric cancer. Methods DC-PCR was used to quantitatively detect HER2 and C-myc amplification in gastric primary cancer, paracancerous, metastatic lymph nodes and distant metastasis. Results The frequency of HER2 amplification was higher in the proximal gastric cancer group than in the distal gastric cancer group (84.6% and 26.3%, respectively, P<0.05). The invaded serosa group was significantly higher than the noninvasive serosa group. (66.7% and 28.6%, P<0.005). There was a significant difference in HER2 amplification between stage IV gastric cancer and stage I and II gastric cancer (P<0.05). The frequency of amplification of C-myc in primary gastric cancer and metastatic lymph nodes was 18.8% and 23.8%, respectively, and in 2 distant metastases. Conclusion HER2 and C-myc amplification are related to the progression of gastric cancer. Near and distal gastric cancer may have different genetic pathways. DC-PCR is a sensitive and reliable gene quantification technology.