Wang Lin, Zhang Xiao-Ying, Xu Ling, Liu Wen-Jun, Zhang Juan, Zhang Jian-Ping
Department of Pathology, Shandong University School of Medicine, Jinan, Shandong 250012, P.R. China.
Oncol Lett. 2011 Jul;2(4):707-712. doi: 10.3892/ol.2011.292. Epub 2011 Apr 14.
Subtypes of intestinal metaplasia may have different manifestations in the carcinogenesis of gastric mucosa. The present study aimed to investigate expression of murine double minute gene 2 (mdm2) in atypical intestinal metaplasia (AIM) and its relationship to gastric carcinoma. Intestinal metaplasia (IM) specimens were obtained from 58 cases. Using a novel classification of IM, the specimens were classified according to morphological changes exhibited in the gastric mucosa; specifically, atypical intestinal metaplasia (AIM) and simple intestinal metaplasia (SIM). The gatric carcinoma specimens were then compared with types I, II and III IM based on different substances present in the mucous. Envision immunohistochemical technique was applied to the detection of the expression of p53 and mdm2 in 58 IM and 30 gastric carcinoma cases. Expression of both p53 and mdm2 proteins was found to be higher in gastric carcinomas (p53, 56.67%, 17/30 and mdm2, 53.33%, 16/30) and AIM (p53, 51.85%, 14/27 and mdm2, 51.85%, 14/27) as compared to SIM (p53, 25.81%, 8/31 and mdm2, 19.35%, 6/31) (P<0.05). A similar pattern of expression of mdm2 protein was found in type I (36.84%, 7/19), type II (38.46%, 10/26) and type III (23.08%, 3/13) IM and gastric carcinoma (53.33%, 16/30). p53 expression was higher in gastric carcinoma (56.67%) compared to type I IM (26.32%) (P<0.05). However, no differences were evident among type II (42.31%, 11/26), type III (46.15%, 6/13) IM and gastric carcinoma. AIM may reveal the precancerous nature of gastric carcinoma more clearly than SIM or the conventional IM subtypes. Additionally, AIM may be involved as a preneoplastic lesion and therefore be an effective indicator in the clinical follow-up of gastric carcinoma patients.
肠化生的亚型在胃黏膜癌变过程中可能有不同表现。本研究旨在探讨鼠双微体基因2（mdm2）在非典型肠化生（AIM）中的表达及其与胃癌的关系。从58例患者获取肠化生（IM）标本。采用一种新的IM分类方法，根据胃黏膜呈现的形态学变化对标本进行分类；具体而言，分为非典型肠化生（AIM）和单纯肠化生（SIM）。然后根据黏液中存在的不同物质，将胃癌标本与I型、II型和III型IM进行比较。采用Envision免疫组化技术检测58例IM和30例胃癌病例中p53和mdm2的表达。结果发现，与SIM（p53，25.81%，8/31；mdm2，19.35%，6/31）相比，胃癌（p53，56.67%，17/30；mdm2，53.33%，16/30）和AIM（p53，51.85%，14/27；mdm2，51.85%，14/27）中p53和mdm2蛋白的表达均较高（P<0.05）。在I型（36.84%，7/19）、II型（38.46%，10/26）和III型（23.08%，3/13）IM以及胃癌（53.33%，16/30）中发现了类似的mdm2蛋白表达模式。与I型IM（26.32%）相比，胃癌中p53表达更高（56.67%）（P<0.05）。然而，II型（42.31%，11/26）、III型（46.15%，6/13）IM与胃癌之间无明显差异。与SIM或传统IM亚型相比，AIM可能更清楚地揭示胃癌的癌前性质。此外，AIM可能作为癌前病变参与其中，因此是胃癌患者临床随访中的一个有效指标。
