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目的为探讨胃癌前组织及胃癌中 Bax 基因表达状况及其与细胞凋亡的关系.方法应用原位杂交和免疫组化技术检测正常胃粘膜10例、慢性胃炎72例和胃癌53例中/Bax 基因的表达,并采用凋亡细胞原位检测方法对组织切片中凋亡细胞进行原位观察和比较.结果 Bax 基因在正常胃粘膜及不同胃粘膜病变中均有不同程度的表达.Bax mRNA 在肠化生中的表达率为69.4%,显著高于正常胃粘膜(20.0%,X~2=7.892,P<0.01).Bax 蛋白在肠化生中的表达率为77.8%,显著高于正常胃粘膜(30.0%)、萎缩性胃炎(43.8%)、异型增生(50.0%)和胃癌(54.7%)(X~2=8.129,5.829,4.548,4.951,P<0.01及 P<0.05).X~2检验表明两种方法检测阳性率差异无显著性.凋亡细胞原位检测结果显示,Bax 蛋白表达阳性肠化生、异型增生和胃癌中的凋亡细胞指数显著高于 Bax 蛋白阴性组(t=2.283,2.557,3.928,P<0.05及 P<0.01),Bax 蛋白表达状态与细胞凋亡指数呈正相关(r=0.439,P<0.01).结论 Bax 基因对胃癌前组织及胃癌细胞凋亡具有促进性调控作用,细胞凋亡调控异常在胃癌发病中可能起重要作用.
Objective To investigate the expression of Bax gene and its relationship with apoptosis in gastric precancerous tissues and gastric cancer. Methods In situ hybridization and immunohistochemistry were used to detect normal gastric mucosa in 10 cases, chronic gastritis in 72 cases, and gastric cancer in 53 cases. Gene expression and apoptotic cell in situ detection methods were used to observe and compare apoptotic cells in tissue sections in situ. Results Bax genes were expressed to varying degrees in normal gastric mucosa and different gastric mucosal lesions. The expression rate in intestinal metaplasia was 69.4%, which was significantly higher than that in normal gastric mucosa (20.0%, X~2=7.892, P<0.01). The expression rate of Bax protein in intestinal metaplasia was 77.8%, which was significantly higher than normal. Gastric mucosa (30.0%), atrophic gastritis (43.8%), dysplasia (50.0%), and gastric cancer (54.7%) (X~2=8.129, 5.829, 4.548, 4.951, P<0.01 and P<0.05). X The ~2 test showed that there was no significant difference in the positive rate detected by the two methods. The in situ detection of apoptotic cells showed that the apoptotic cell index was significantly higher in Bax protein positive intestinal metaplasia, dysplasia and gastric cancer than in the Bax protein negative group ( t=2.283,2.557,3.928, P<0.05 and P<0.01), Bax protein expression status and cell apoptosis index were positive (R = 0.439, P <0.01). Conclusion Bax gene facilitative role in the regulation of apoptosis in human gastric carcinoma and gastric carcinoma, abnormal regulation of apoptosis may play an important role in the pathogenesis of gastric cancer.