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目的：探索胃粘膜癌变的病理学指标，为更有效地防治这类病变提供可靠依据。方法：对胃粘膜良恶性病变（共１２０例），用免疫组织化学ＬＳＡＢ法检测生物素化的菜豆凝集素受体（ＰＨＡＲ）、ｐ５３ 蛋白及增殖细胞核抗原（ＰＣＮＡ）的表达。结果：（１）ＰＣＮＡ在正常胃粘膜组阳性率最低，与各组间均有差异（Ｐ＜ ０．０００５），随病变加重而递增。同时，强阳性率在中～重度不典型增生组与腺癌组之间有差异（Ｐ＜ ０．０５）。（２） ｐ５３蛋白在正常胃粘膜、慢性浅表性胃炎活动性（ＣＳＧ）、慢性萎缩性胃炎（ＣＡＧ）、中～重度肠化及轻度不典型增生４组阴性。中～重度不典型增生组及腺癌组阳性，二者间有差异（Ｐ＜ ０．０５）。（３）ＰＨＡＲ阳性率在正常胃粘膜组阴性，随病变程度加重逐步递增，且与各组间均有差异（Ｐ＜ ０．０５）。中～重度不典型增生组与腺癌组在ＰＨＡＲ强阳性率上有差异（Ｐ＜ ０．０５）。（４）腺癌组ＰＨＡＲ、ＰＣＮＡ、ｐ５３蛋白强阳性率三项指标之间有相关性（Ｐ＜ ０．０００５）。结论：ＰＨＡＲ的强阳性表达可作为区分中～重度不典型增生与腺癌的辅助指标。ｐ５３ 蛋白阳性，若同时伴有ＰＨＡＲ强阳性表达，是胃癌的明显标志。ＣＡＧ和中～重度肠化属早期癌
Objective: To explore the pathological changes of gastric mucosal carcinogenesis and provide a reliable basis for more effective prevention and treatment of such lesions. METHODS: The expression of biotinylated PHAR, p53 protein and proliferating cell nuclear antigen (PCNA) was detected by immunohistochemical LSAB method for benign and malignant lesions of gastric mucosa (120 cases in total). Results: (1) The positive rate of PCNA in the normal gastric mucosa group was the lowest, and it was different from each group (P<0.0005). It increased with the worsening of the lesions. At the same time, the strong positive rate in the moderate to severe atypical hyperplasia group and adenocarcinoma group were different (P<0.05). (2) p53 protein was negative in normal gastric mucosa, active chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), moderate to severe intestinal metaplasia, and mild dysplasia. The moderate-to-severe dysplasia and adenocarcinoma groups were positive, with a difference between the two groups (P<0.05). (3) The positive rate of PHAR was negative in the normal gastric mucosa group, gradually increased with the severity of the lesion, and there was a difference between the groups (P < 0.05). The PHAR strong positive rate was significantly different between moderate-severe atypical hyperplasia group and adenocarcinoma group (P<0.05). (4) There was a correlation between PHAR, PCNA and strong positive rate of p53 protein in adenocarcinoma group (P<0.0005). Conclusion: The strong positive expression of PHAR can be used as an auxiliary index to distinguish moderate to severe atypical hyperplasia and adenocarcinoma. Positive p53 protein, if accompanied by strong expression of PHAR, is a clear sign of gastric cancer. CAG and moderate to severe intestinal metastasis are early cancers