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目的:探讨RUNX3蛋白表达与幽门螺杆菌(Helicobacter pylori)感染相关胃黏膜病变的关系。方法:选取山东省临朐县胃癌高发区具有明确胃黏膜病理诊断的1 026例H.pylori感染者为研究对象,采用免疫组织化学方法,检测最高诊断部位胃黏膜组织RUNX3蛋白表达状况。结果:在1 026例患有不同胃黏膜病变的研究对象中,RUNX3表达阳性者为359例,表达率为35.0%(359/1 026),表达率随胃黏膜病变的加重呈逐渐下降趋势,由浅表性胃炎/正常(superficial gastritis/normal,SG/N)的65.6%(40/61)降至异型增生(dysplasia,DYS)的22.4%(60/268,P<0.01)。以SG/N为对照组,RUNX3表达阳性为参照,RUNX3表达阴性者患慢性萎缩性胃炎(chronic atrophic gastritis,CAG)、肠上皮化生(intestinal metaplasia,IM)和DYS的风险分别为表达阳性者的2.83倍[oddsratio(OR)=2.83,95%confidence interval(CI)=1.58～5.06)],3.52倍(OR=3.52,95%CI=1.98～6.24)和7.19倍(OR=7.19,95%CI=3.81-13.56)。进一步分析显示,不论吸烟(或饮酒)状况如何,RUNX3表达阴性者与表达阳性且不吸烟(或不饮酒)者相比,患IM和DYS的风险均明显增加,ORs在2.78～12.29之间。结论:RUNX3蛋白表达水平与H.pylori感染相关胃黏膜病变程度呈明显的负相关,提示RUNX3表达下调可能在胃黏膜病变的演变过程中起重要作用。
Objective: To investigate the relationship between RUNX3 protein expression and gastric mucosal lesion in Helicobacter pylori infection. Methods: One hundred and twenty-two cases of H.pylori infection were identified in the high-risk area of gastric cancer in Linli County, Shandong Province. The immunohistochemical method was used to detect the expression of RUNX3 protein in gastric mucosa at the highest diagnosis site. Results: Of the 1 026 subjects with different gastric mucosal lesions, 359 (35.0%) were positive for RUNX3, the expression rate of RUNX3 was gradually decreased with the increase of gastric mucosal lesions, Was reduced from 65.6% (40/61) in superficial gastritis / normal (SG / N) to 22.4% (60/268, P <0.01) in dysplasia (DYS). The positive rates of RUNX3 expression in patients with negative RUNX3 expression were significantly higher than those with chronic atrophic gastritis (CAG), intestinal metaplasia (IM) and DYS in SG / N as control group (OR = 3.52, 95% CI = 1.98-6.24) and 7.19-fold (OR = 7.19, 95% CI) of 2.83 times (oddsratio (OR) = 2.83, 95% confidence interval CI = 3.81-13.56). Further analysis showed that regardless of smoking (or drinking) status, patients with negative RUNX3 expression had a significantly increased risk of IM and DYS compared with those with positive expression and no smoking (or no alcohol consumption), with odds ratios between 2.78 and 12.29. CONCLUSIONS: RUNX3 protein expression is negatively correlated with the degree of gastric mucosal lesions related to H. pylori infection, suggesting that down-regulation of RUNX3 may play an important role in the development of gastric mucosal lesions.