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目的 研究微卫星不稳定性 (MSI)在胃癌发生、发展中的作用。方法 使用聚合酶链反应 简单序列长度多态性 (PCR SSCP)的方法 ,检测 36例活检和手术切除胃癌标本及 30例肠化生标本的MSI。结果 36例胃癌中 ,有 15例检出 1个以上位点MSI ,总阳性率为 41.7% ;中 高分化腺癌MSI检出率为 6 6 .7% (10 / 15例 ) ,显著高于低分化腺癌的 2 6 .3% (5 / 19例 ,P <0 .0 5 ) ;肠型胃癌MSI阳性率为6 4.7% (11/ 17例 )显著高于弥漫型胃癌的 2 2 .2 % (4 / 18例 ,P <0 .0 5 ) ;MSI与胃癌大小、发生部位、分期及幽门螺杆菌 (Hp)感染无显著相关。 3例早期胃癌MSI均阳性 ,30例肠化生标本中有 9例检出MSI,阳性率为 30 .0 %。Ⅰ、Ⅱ、Ⅲ型肠化生MSI阳性率分别为 2 5 .0 % (2 / 8例 )、2 5 .0 % (3/ 12例 )、40 .0 % (4 /10例 )。三者间差异无显著性。结论 MSI是胃癌多步骤发生过程中的早期分子标志 ,在胃癌的发生过程中可能起重要作用。
Objective To study the role of microsatellite instability (MSI) in the occurrence and development of gastric cancer. METHODS: Using the polymerase chain reaction simple sequence length polymorphism (PCR-SSCP) method, 36 cases of biopsy and surgical resection of gastric cancer specimens and 30 cases of intestinal metaplasia were examined for MSI. Results Of the 36 cases of gastric cancer, 15 were found to have more than one locus MSI, the total positive rate was 41.7%; the MSI detection rate of moderately-differentiated adenocarcinoma was 66.7% (10/15), significantly higher than low 26.3% of differentiated adenocarcinomas (5/19 cases, P < 0.05); MSI positive rate of intestinal type gastric cancer was 6.7% (11/17 cases) was significantly higher than that of diffuse type gastric cancer 22.2 cases % (4 / 18 cases, P <0.05); MSI was not significantly associated with gastric cancer size, site of occurrence, stage, and Helicobacter pylori (Hp) infection. Three cases of early gastric cancer were all positive for MSI, and 30 cases of intestinal metaplasia detected MSI in 9 cases, with a positive rate of 30.0%. The positive rate of MSI in patients with type I, II, and III in intestinal metaplasia was 25.0% (2/8 cases), 25.0% (3/12 cases), and 40.0% (4/10 cases) respectively. There was no significant difference among the three groups. Conclusion MSI is an early molecular marker in the multistep development of gastric cancer and may play an important role in the development of gastric cancer.