CAJ | 학술논문

目的探讨叉头框蛋白A2(Foxa2)蛋白的表达与胃息肉癌变之间的相关性及其早期报警价值.方法对解放军总医院2011年11月至2012年10月接受胃镜检查的患者,根据计算机随机号码抽取2000例患者,其中170例在胃镜检查时发现胃息肉样病变及可疑癌变病灶,进行内镜下活检,对所取组织进行病理学分型,其中正常胃黏膜30例、炎性或增生性息肉35例、胃底腺息肉42例、腺瘤性息肉31例、进展期胃癌32例.采用ABC免疫组织化学染色法和组织水平反转录-PCR方法,检测不同病理状态组织中Foxa2的表达水平,结合临床对结果进行相关分析.结果 Foxa2在正常胃黏膜中仅有少量表达,表达阳性率为3.6％±1.3％；在炎性或增生性息肉、腺瘤性息肉和胃癌组织中表达依次增高,分别为33.1％±8.0％、71.4％±1.7％和96.3％±0.9％,两两之间差异均有统计学意义(均P＜0.05)；胃底腺息肉中Foxa2的表达阳性率为35.6％±5.6％,与炎性或增生性息肉组差异无统计学意义(P＞0.05),但明显高于正常胃黏膜组(P＜0.05),且低于腺瘤性息肉组(P＜0.05)；对于胃息肉患者病变部位Foxa2的表达与临床相关资料分析结果显示,Foxa2的表达与患者性别、年龄、病变部位、幽门螺旋杆菌感染以及质子泵抑制剂使用均无明显相关性(均P＞0.05),而与息肉大小存在相关性(rs=0.69,P＜0.05).结论不同类型胃息肉中Foxa2蛋白的表达水平不同,Foxa2蛋白的表达可作为息肉癌变风险预测的临床诊断指标.
목적 탐토차두광단백A2(Foxa2)단백적표체여위식육암변지간적상관성급기조기보경개치.방법 대해방군총의원2011년11월지2012년10월접수위경검사적환자,근거계산궤수궤호마추취2000례환자,기중170례재위경검사시발현위식육양병변급가의암변병조,진행내경하활검,대소취조직진행병이학분형,기중정상위점막30례、염성혹증생성식육35례、위저선식육42례、선류성식육31례、진전기위암32례.채용ABC면역조직화학염색법화조직수평반전록-PCR방법,검측불동병리상태조직중Foxa2적표체수평,결합림상대결과진행상관분석.결과 Foxa2재정상위점막중부유소량표체,표체양성솔위3.6％±1.3％；재염성혹증생성식육、선류성식육화위암조직중표체의차증고,분별위33.1％±8.0％、71.4％±1.7％화96.3％±0.9％,량량지간차이균유통계학의의(균P＜0.05)；위저선식육중Foxa2적표체양성솔위35.6％±5.6％,여염성혹증생성식육조차이무통계학의의(P＞0.05),단명현고우정상위점막조(P＜0.05),차저우선류성식육조(P＜0.05)；대우위식육환자병변부위Foxa2적표체여림상상관자료분석결과현시,Foxa2적표체여환자성별、년령、병변부위、유문라선간균감염이급질자빙억제제사용균무명현상관성(균P＞0.05),이여식육대소존재상관성(rs=0.69,P＜0.05).결론 불동류형위식육중Foxa2단백적표체수평불동,Foxa2단백적표체가작위식육암변풍험예측적림상진단지표.
Objective To explore the expression of Foxa2 in different pathological types of gastric polyps and examine the correlation with cancerous risk.Methods According to computerize random number,a total of 2000 patients were selected to receive endoscopic biopsy during November 2011 to October 2012.Tissues were harvested from 170 with gastric polyps and suspicious cancerous lesions and their histological types detected.There were hyperplastic polyps(n =35),adenomatous polyps(n =31),fundic gland polyps (n =42),advanced gastric cancer tissues (n =32) and normal gastric mucosa tissues (n =30).ABC immunohistochemical staining and reverse transcription(RT)-PCR were employed to detect the expression of Foxa2 in these different types of tissues.Imagepro plus was used for quantitative and statistical analyses.Results A low-level expression of Foxa2 was 3.6％ ± 1.3％ in normal gastric mucosa group.And its expreesion gradually higher in proliferative inflammatory polyp group(33.1％ ± 8.0％),adenomatous polyp group (71.4％ ± 1.7％) and gastric cancer group(96.3％ ±0.9％,all P ＜0.05).Its expression was 35.6％ ± 5.6％ in fundic gland polyps,similar to that of proliferative inflammatory polyp group (P ＞ 0.05),it was markedly lower than the gastric cancer group (P ＜ 0.05) and higher than the normal gastric mucosa group (P ＜ 0.05).Correlation analyses of clinicopathological parameters showed that no significant correlation existed between its expression and patient gender,age,predilection,Helicobacter.pylori infection or proton pump inhibitor used(all P ＞ O.05).However,the size of polyps was correlated with Foxa2 (rs =0.69,P ＜ 0.05).Conclusion The expression level of Foxa2 in different types of gastric polyps may be used as a clinical predicator of polyps risk.