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目的:探讨核因子-κB(nuclearfactor-KappaB,NF-κB)在癌前病变及胃癌组织中的表达及其与细胞毒素相关抗原A幽门螺杆菌(CagA+Hpylori)感染之间的关系.方法:慢性浅表性胃炎34例,肠腺化生31例,不典型增生34例,胃癌55例,应用免疫组化方法(SABC法)检测NF-κBp65的表达,以14C-呼气试验、快速尿素酶试验和Warthin-Starry银染色检测Hpylori,采用斑点金免疫渗滤法检测患者血清抗HpyloriCagAIgG抗体,分析NF-κBp65表达与CagA+Hpylori感染之间、以及与胃癌组织学分型、临床病理分期、淋巴结转移的关系.结果:在慢性浅表性胃炎、肠腺化生、不典型增生和胃癌组中,NF-κBp65阳性表达率分别为15.0%,41.9%,64.7%和78.2%,呈逐渐增高趋势,各组间有显著性差异(χ2=43.98,P<0.01);Hpylori感染率分别为70.0%,67.7%,73.5%和54.5%,各组间无显著性差异(P>0.05).CagA+Hpylori构成比分别为53.6%,61.9%,68.0%和73.3%,各组间无显著性差异(P>0.05).在肠化组中,Hpylori阳性和CagA+Hpylori感染的患者NF-κBp65阳性表达率分别为57.1%和76.9%,显著高于同组无Hpylori感染的10.0%(χ2=6.18,P<0.05)和CagA-Hpylori感染者的25.0%(χ2=5.45,P<0.05).在胃癌组中,NF-κBp65阳性表达与T分期(χ2=5.91,P<0.05)及淋巴结转移有关(χ2=7.47,P<0.05),但与胃癌组织学分型无关(P>0.05).结论:NF-κB的异常活化在胃癌前病变及癌变过程中起作用,早期的活化与CagA+Hpylori感染有关.
Objective: To investigate the expression of nuclear factor-κB (NF-κB) in precancerous lesions and gastric carcinoma and its relationship with CagA + Hpylori infection.Methods: 34 cases of chronic superficial gastritis, 31 cases of intestinal metaplasia, 34 cases of atypical hyperplasia and 55 cases of gastric cancer. The expression of NF-κBp65 was detected by immunohistochemical method (SABC method). 14C-breath test, Hpylori was detected by enzyme-linked immunosorbent assay (ELISA) and Warthin-Starry silver staining. Serum anti-HpyloriCagAIgG antibody was detected by dot immunogold filtration assay. The relationship between NF-κBp65 expression and CagA + Hpylori infection, histological type, clinical pathological stage, lymph node Metastasis.Results: The positive expression rate of NF-κBp65 in chronic superficial gastritis, glandular metaplasia, atypical hyperplasia and gastric cancer group were 15.0%, 41.9%, 64.7% and 78.2%, respectively, showing an increasing trend (Χ2 = 43.98, P <0.01). The infection rates of Hpylori were 70.0%, 67.7%, 73.5% and 54.5% respectively, there was no significant difference between the two groups (P> 0.05) .CagA + Hpylori constituent ratios were 53.6%, 61.9%, 68.0% and 73.3%, respectively, with no significant difference among the groups (P> 0.05) The positive rates of NF-κBp65 in Hpylori-positive and CagA + Hpylori-infected patients were 57.1% and 76.9%, respectively, which were significantly higher than those in Hpylori infection (χ2 = 6.18, P <0.05) The positive expression of NF-κBp65 was correlated with T stage (χ2 = 5.91, P <0.05) and lymph node metastasis (χ2 = 7.47, P <0.05) in patients with Hpylori infection (χ2 = 5.45, ), But not with the histological type of gastric cancer (P> 0.05) .Conclusion: Aberrant activation of NF-κB plays a role in precancerous lesions and carcinogenesis of gastric cancer. Early activation is associated with CagA + Hpylori infection.