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目的研究慢性浅表性胃炎(CSG),慢性萎缩性胃炎(CAG),不典型增生(Dys)和胃癌(GC)病变中,细胞增殖、细胞凋亡和DNA 倍体变化的规律及对疾病发生的可能作用.方法 CSG 15例,CAG 15例,Dys 16例和GC 50例经 TUNEL方法标记凋亡细胞和碘化丙啶标记细胞 DNA 双染色,用流式细胞仪检测细胞凋亡指数(AI)和细胞增殖指数(PI)及 DNA 指数(DI).结果在 CSG,CAG,Dys 和 GC 中,A1分别为10.2%,11.9%,18.3%和6.6%.GC 的 AI 显著低于 Dys 和 CAG(P<0.05);PI 为14.9%,20.1%,24.6%和31.8%.GC 的 PI 显著地高于其余3组(P<0.05),Dys 的 PI 亦显著高于 CSG(P<0.05);AI/PI 比值分别为0.65,0.57,0.72和0.22.GC 的 AI/PI 比值显著地低于其余3组(P<0.05).PI 与胃癌的浸润深度、转移、分期及 DNA 倍体类型有关.CSG 和 CAG 的 DNA 均为二倍体,16例 Dys 中有4例(25%)为异倍体 DNA,50例 GC 有41例(82%)的 DNA 为异倍体.异倍体 DNA 的胃癌,其 PI(33.6%)明显增高,而 AI/PI(0.19%)却明显低于二倍体胃癌(分别为23.4%和0.35%),P<0.05.AI 与 PI 在 CSG 和 CAG中呈明显正相关(r 分别为0.52和0.55,P<0.05).但在 Dys和 GC 中并无明显的关系(P>0.05).结论胃癌及癌前病变存在着细胞增殖和凋亡平衡的失调,表现为细胞增殖增加和凋亡减少.细胞增殖的显著优势是胃癌形成的细胞动力学特征.异倍体 DNA 最早出现于不典型增生,而在胃癌时最为显著.异倍体 DNA 的胃癌有明显高的细胞增殖指数和显著低的凋亡指数与增殖指数比值,提示 DNA倍体的检测有助于早期发现癌前病变、早期诊断胃癌和评价肿瘤的恶性程度.
Objective To study the regularity of cell proliferation, apoptosis, and DNA ploidy in chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), atypical hyperplasia (Dys), and gastric cancer (GC) lesions and to investigate the pathogenesis of chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), dysplasia (Dys), and gastric cancer (GC). Possible effects. METHODS 15 cases of CSG, 15 cases of CAG, 16 cases of Dys and 50 cases of GC were labeled with apoptotic cells and propidium iodide-labeled cells by TUNEL method. DNA was detected by flow cytometry (AI). ) and cell proliferation index (PI) and DNA index (DI). Results In CSG, CAG, Dys and GC, A1 was 10.2%, 11.9%, 18.3% and 6.6%, respectively. AI of GC was significantly lower than that of Dys and CAG. (P<0.05); PI was 14.9%, 20.1%, 24.6%, and 31.8%. The PI of GC was significantly higher than the other three groups (P<0.05), and the PI of Dys was also significantly higher than that of CSG (P<0.05). The AI/PI ratios of AI/PI ratios of 0.65, 0.57, 0.72, and 0.22.GC were significantly lower than those of the other three groups (P<0.05). PI was associated with invasive depth, metastasis, staging, and DNA ploidy type of gastric cancer. The DNA of both CSG and CAG was diploid, 4 out of 16 Dys (25%) were aneuploid DNA, and 41 (82%) of 50 GC samples were aneuploid. Aneuploid DNA In gastric cancer, the PI (33.6%) was significantly higher, while AI/PI (0.19%) was significant. Lower than diploid gastric cancer (23.4% and 0.35%, respectively), P<0.05. AI was positively correlated with PI in CSG and CAG (r 0.52 and 0.55, respectively, P<0.05). However, in Dys and GC There was no significant relationship between them (P>0.05). Conclusion Gastric cancer and precancerous lesions have imbalances in the balance of cell proliferation and apoptosis, manifested as increased cell proliferation and decreased apoptosis. The significant advantage of cell proliferation is the cellular dynamics of gastric cancer formation. Characteristics. Aneuploid DNA first appeared in atypical hyperplasia and was most prominent in gastric cancer. Gastric cancer with aneuploid DNA had a significantly higher cell proliferation index and a significantly lower ratio of apoptosis index to proliferation index, suggesting DNA ploidy. The detection of early detection of precancerous lesions, early diagnosis of gastric cancer and evaluation of the degree of malignancy of the tumor.