胃黏膜的细胞增殖与倍性：幽门螺杆菌的作用

Cellular proliferation and ploidy of the gastric mucosa: the role of Helicobacter pylori.

作者信息

Abdel-Wahab M, Attallah A M, Elshal M F, Abdel-Raouf M, Zalata K R, el-Ghawalby N, Ezzat F

机构信息

Biotechnology Research Laboratories, Mansoura University, Egypt.

出版信息

Hepatogastroenterology. 1997 May-Jun;44(15):880-5.

PMID:9222708

Abstract

BACKGROUND/AIMS: Recently, H. pylori has been recognized as a risk factor for gastric adenocarcinoma. As such, we have analyzed the DNA content of gastric epithelial cells in an attempt to reveal the role of H. pylori in gastric carcinogenesis.

METHODOLOGY

Fifty-three subjects presented with gastric dyspepsia, 39 males and 14 females, with a mean age of 42.15 (+/- 13.16) years. They were referred to the out-patient clinic to undergo endoscopic examination for the first time. Biopsy specimens from the antrum of each subject were subjected to culture for the presence of H. pylori histologic diagnosis, and DNA flow cytometry for the analysis of cellular proliferation and DNA policy.

RESULTS

The endoscopic diagnoses were normal appearance (12), Gastric ulcer (12), duodenal ulcer (29). Thirty-eight (72%) subjects were positive, and 15 (28%) subjects were negative for H. pylori. Abnormal DNA-content (aneuploidy) was found in specimens from the antrums of 3 patients, 2 patients with duodenal ulcers (DU, and one with a gastric ulcer (GU). The cellular proliferation detected by flow cytometry in the form of proliferative index (PI; percentage of cells in the DNA S and G2M phases) was 27.88 (+/- 12.48) and 14.17 (+/-2.94) in the antrums of those positive and negative for H. pylori, respectively. A very significant increase in the PI (p < 0.005) was found between subjects positive and negative for H. pylori. Patients with DU and H pylori infection had the highest PI, and the PI was significantly higher than in patients with DU, but without infection. Regarding histology, there was a significant increase in the PI in the presence of H. pylori infection in either CAG or dysplasia groups as compared to cases without infection in the same groups.

CONCLUSION

These results show that H. pylori infection is associated with changes in the DNA-content and cellular proliferative activity, suggesting that H. pylori may be implicated in gastric carcinogenesis. Also, the significant increase in the PI along the progression of severity of the disease suggests that measuring this parameter might allow more accurate monitoring of patients, so that a targeted therapeutic protocol may be defined.

摘要

背景/目的：最近，幽门螺杆菌已被公认为胃腺癌的一个风险因素。因此，我们分析了胃上皮细胞的DNA含量，试图揭示幽门螺杆菌在胃癌发生中的作用。

方法

53例有胃消化不良症状的受试者，男性39例，女性14例，平均年龄42.15（±13.16）岁。他们首次到门诊接受内镜检查。对每个受试者胃窦的活检标本进行幽门螺杆菌培养以确定其存在情况、组织学诊断，并进行DNA流式细胞术以分析细胞增殖和DNA倍体情况。

结果

内镜诊断结果为外观正常（12例）、胃溃疡（12例）、十二指肠溃疡（29例）。38例（72%）受试者幽门螺杆菌检测呈阳性，15例（28%）受试者呈阴性。在3例患者的胃窦标本中发现DNA含量异常（非整倍体），其中2例为十二指肠溃疡患者，1例为胃溃疡患者。通过流式细胞术检测的细胞增殖以增殖指数（PI；处于DNA S期和G2M期的细胞百分比）表示，幽门螺杆菌阳性和阴性受试者胃窦中的PI分别为27.88（±12.48）和14.17（±2.94）。幽门螺杆菌阳性和阴性受试者之间的PI有非常显著的升高（p<0.005）。十二指肠溃疡合并幽门螺杆菌感染的患者PI最高，且PI显著高于未感染的十二指肠溃疡患者。在组织学方面，与同一组未感染的病例相比，慢性萎缩性胃炎（CAG）或发育异常组中存在幽门螺杆菌感染时PI显著升高。