摘要
目的检测瘦素(leptin)及胃促生长素(ghrelin)在胃癌及其癌前病变中的表达及相关性,探讨两者在胃黏膜癌变过程中的作用,为胃癌的早期诊断及治疗提供一定的理论依据。方法 139例患者分为慢性非萎缩性胃炎组30例、慢性萎缩性胃炎非肠上皮化生(简称肠化)组30例、慢性萎缩性胃炎伴肠化组30例、异型增生组19例、胃癌组30例,采用免疫组织化学法检测ghrelin和leptin在胃黏膜中的表达,分析两者在胃黏膜癌变过程中的表达变化及相关性。结果 ghrelin在非萎缩性胃炎组、萎缩非肠化组、萎缩伴肠化组、异型增生组、胃癌组中表达阳性率分别为80.00%、53.33%、43.33%、21.05%、16.67%,表达递减,萎缩非肠化组与萎缩伴肠化组差异无统计学意义(P>0.05),萎缩伴肠化组与异型增生组差异无统计学意义(P>0.05),异型增生组与胃癌组差异无统计学意义(P>0.05),余各组间比较差异均有统计学意义(P<0.05)。上述5组中leptin表达阳性率分别为10.00%、33.33%、53.33%、73.68%、80.00%,表达递增,非萎缩性胃炎组与萎缩非肠化组差异无统计学意义(P>0.05),萎缩非肠化组与萎缩伴肠化组差异无统计学意义(P>0.05),萎缩伴肠化组与异型增生组差异无统计学意义(P>0.05),异型增生组与胃癌组差异无统计学意义(P>0.05),余各组间比较差异均有统计学意义(P<0.05)。在萎缩伴肠化组、异型增生组、胃癌组中leptin与ghrelin的表达呈显著负相关(P<0.05)。结论 ghrelin在胃黏膜癌变过程中表达呈递减趋势,其在胃黏膜表达的特异性降低可作为胃癌诊断指标继续研究;leptin在胃黏膜癌变过程中表达呈递增趋势,提示leptin与胃癌发生相关,其在胃黏膜中高表达可被视为胃癌早期诊断的监测指标;胃黏膜癌变过程中,ghrelin与leptin可能相互作用,呈负相关,两者的异常表达参与了胃黏膜损伤及癌变,联合检测有助于胃癌的早期诊断。
Objective This paper detected the expression of leptin and ghrelin in the changes in gastric cancer and its precancerous lesions,analyzed the correlation between them,and discussed the role of ghrelin and leptin in the process of gastric carcinogenesis in order to provide some theoretical basis for the early diagnosis and treatment of gastric cancer.Methods 139 patients were selected to participate in the experiment in which 30 cases were assigned to chroic non-atrophic gastritis(CNG),30 cases to chronic atrophic gastritis(CAG)without intestinal metaplasia,30 cases to CAG with intestinal metaplasia,19 cases to dysplasia(Dys),and 30 cases to gastric cancer(GC).Immunohistochemistry was used to detect the expression and correlation between ghrelin and leptin in gastric cancer and itsprecancerous lesions.Results In the group of CNG,CAG with intestinal metaplasia,CAG without intestinal metaplasia,Dys and GC,the positive rate of ghrelin was 80.00%,53.33%,43.33%,21.05%and 16.67%,respectively,showing agradually decrease.There were no significant differences between the group of CAG without intestinal metaplasia and with intestinal metaplasia(P>0.05),CAG with intestinal metaplasia and Dys(P>0.05),Dys and gastric cancer(P>0.05),but there were significant differences between the other groups(P<0.05).However,the positive rate of leptin was 10.00%,33.33%,53.33%,73.68% and 80.00%,respectively,showing agradually increase.There were no significant differences between the group of CNG and CAG without intestinal metaplasia(P>0.05),CAG without intestinal metaplasia and with intestinal metaplasia(P >0.05),CAG with intestinal metaplasia and Dys(P>0.05),Dys and gastric cancer(P>0.05),but there were significant differences between the other groups(P<0.05).Ghrelin and leptin expression were negatively correlated between the group of CAG with intestinal metaplasia,Dys and GC(P<0.05).Conclusions There is a decrease in the expression ghrelin,suggesting that the specific decrease in the expression of ghrelin in the gastric mucosa may be used as a diagnostic index for gastric cancer.There is an increase in the expression of leptin,suggesting that leptin is associated with the occurrence of gastric cancer,and its high expression in the gastric mucosa may be considered as a monitoring indicator for early diagnosis of gastric cancer.In the process of gastric carcinogenesis,ghrelin and leptin may interact negatively.Their abnormal expressions are involved in gastric mucosa injury and carcinogenesis.Combined detection is helpful for early diagnosis of gastric cancer.
出处
《国际消化病杂志》
CAS
2018年第1期42-47,共6页
International Journal of Digestive Diseases
