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目的:了解细胞增殖及基因bcl-2、p53的表达在浅表性胃炎→萎缩性胃炎→肠上皮化生→不典型增生→早期胃癌→进展期胃癌这一演化过程中的意义。方法:采用免疫组化法检测增殖细胞核抗原(PCNA)标记和bcl-2、p53蛋白表达。结果:浅表性胃炎、萎缩性胃炎、肠上皮化生、不典型增生、早期胃癌和晚期胃癌的PCNA指数分别为11.3 % ±2.2% 、18.9% ±6.5% 、20.33% ±7.3% 、40. 03% ±10.6% 、53.08% ±10.9% 和72.44% ±38.4% ;bcl-2表达分别为10.0% 、23.3% 、40.0%、56.7% 、85.7% 和46.7%;p53蛋白表达分别为0% 、0% 、0% 、4.3%、14.3% 和53.3% 。各期病变中的这三项指标绝大多数均有显著差异(P<0.05～0.01)。结论:(1)在胃癌演化过程中,PCNA呈持续上升趋势。(2)在胃癌中,bcl-2蛋白的表达与p53蛋白的表达呈反向关系,前者可能是胃癌早期的行为,后者则可能是胄癌中晚期的行为。
Objective: To understand the significance of cell proliferation and the expression of bcl-2 and p53 genes in superficial gastritis, atrophic gastritis, intestinal metaplasia, atypical hyperplasia, early gastric cancer, and advanced gastric cancer. Methods: Proliferating cell nuclear antigen (PCNA) markers and bcl-2, p53 protein expression were detected by immunohistochemistry. Results: The PCNA indexes of superficial gastritis, atrophic gastritis, intestinal metaplasia, atypical hyperplasia, early gastric cancer and advanced gastric cancer were 11.3%±2.2%,18.9%±6.5%, and 20.33%±7.3%, respectively. The expression of bcl-2 was 10.0%, 23.3%, 40.0%, 56.7%, 85.7% and 46.7%, respectively; the expression of p53 protein was 0%, respectively. 0%, 0%, 4.3%, 14.3%, and 53.3%. The vast majority of these three indicators in each stage of disease have significant differences (P <0.05 ~ 0.01). Conclusion: (1) During the evolution of gastric cancer, PCNA showed a continuous upward trend. (2) In gastric cancer, the expression of bcl-2 protein is inversely related to the expression of p53 protein. The former may be the behavior of early gastric cancer, and the latter may be the behavior of middle to late stage cancer.