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目的 研究胃癌和癌前病变中细胞凋亡与增殖,及其与热休克蛋白70(HSP_(70))表达的关系及临床生物学意义。方法应用免疫组织化学SP法检测158例胃粘膜病变石蜡标本中HSP_(70)和增殖细胞核抗原(PCNA)的表达;并用DNA缺口末端标记法(TUNEL法)对其中56例标本进行细胞凋亡的原位观察。结果 HSP_(70)在胃癌中过表达,与不典型增生和肠上皮化生组相比有显著性差异(P<0.05);细胞增殖指数PI在HSP_(70)阳性表达组比阴性表达组显著增高(P<0.01),但HSP_(70)表达与细胞凋亡指数AI不相关;在慢性浅表性胃炎中AI明显较不典型增生组低(P<0.01),随着病变的进展,胃癌中的AI逐渐降 低,而PI则随病变的恶性进展不断升高。结论 细胞凋亡和细胞增殖平衡失调在胃癌发病中起重要作用;HSP_(70)的过度表达是胃癌发生过程中的早期事件,与细胞增殖相关密切,但与胃癌分化、淋巴结转移和浸润深度无关。
Objective To study the relationship between apoptosis and proliferation and expression of heat shock protein 70 (HSP 70) in gastric carcinoma and precancerous lesions and its clinical significance. Methods Immunohistochemistry SP method was used to detect the expression of HSP 70 and proliferating cell nuclear antigen (PCNA) in paraffin-embedded specimens of 158 gastric mucosa lesions. 56 specimens were subjected to apoptosis by DNA nick end labeling (TUNEL) method. Observe in situ. Results The overexpression of HSP 70 in gastric cancer was significantly different from that in atypical hyperplasia and intestinal metaplasia (P<0.05). The cell proliferation index PI was significantly higher in the HSP 70 positive expression group than in the negative expression group. Increased (P<0.01), but HSP 70 expression was not associated with apoptotic index AI; AI was significantly lower in chronic superficial gastritis than in dysplasia group (P<0.01). With the progression of the disease, gastric cancer The AI gradually decreased while the PI increased with the malignant progression of the lesion. Conclusion The imbalance of cell apoptosis and cell proliferation plays an important role in the pathogenesis of gastric cancer. Overexpression of HSP 70 is an early event in the development of gastric cancer. It is closely related to cell proliferation but not to the differentiation, lymph node metastasis, and depth of gastric cancer. .