| INTRODUCTIONIntestinal metaplasia of gastric (IM) is an important pathologic change of gastric mucosa , many scholars have carried out about IM in different fields, they found IM had a close relationship with gastric cancer. But not all of IM would develop to gastric cancer, then they classified IM in different ways to confirm which one would develop to gastric cancer . At now these methods all have localization and subjection in some way. So it is important that classify IM in new point of view.The differences almong the normal gastric mucosa epithelium, IM and gastric cancer cell is the differentiative types. So we can try to research IM in differentiation. Therefore it is important that how to judge the differetation of cell. At present , except according the morphologic changes ,we also may according the changes of genes and the changes of some enzymes .CDX2 is expressed in the epthelium of small intestinal and colon, where they play a crucial role in the regulation of cell proliferation expressed in the un-differentiated cells of cell crypts , whereas CDX2 is mostly present in the villi or differentiated cell compartment of the small intestine . In addition , the maintenance of intestinal differentiation appears to depend on the presence of CDX2. Mice in which one allele of cdx2 gene has been inactivated have focal loss of intestinal differentiation . Taken together , previous observations indicate that the CDX2 proteins may has an important role in the differentiation of small and large intestine . But It is not clear that the role of CDX2 in the differece subtype of IM.The glutathione S — transferases ( GSTs ) are a family of multifunctional in cluding α,π,μ,θ,ζ and so on. Among them, GST - π has intimated relation with human . People found it could response the differentiative degree of tumor . But it is not clear that the role of GST - π during the developing normal gastric mucosa —IM—gastric cancer .Recently ,many epidemiologic materials show Helicobacter pylori infection play an important role during the stem cell truing to IM. Helicobacter pylori infection not only have a close relationship with the developing of IM, but also have relationship with differe subtypes IM , mainly IM III and IM II. It is not clear that how the infection of H. pylori result to IM and the effection of differentiation of IM.In another way , the gene coding GST - π ( GSTP1) have polymorphism in 5 exon and 6 exon. Many researchs showed the 5 exon polymorphism of GSTP1was associated with a higher risk of human diseases. It is also unclear that polymorphism of GSTPI with IM and H. pylori related IM.So the aims of our study to research the dynamic changing of CDX2 and GST - π by detecting the expression of CDX2 and GST - πin various type IM, and H. pylori effection of IM. Further to inquire the diferentiative characters of IM and H. pylri effection of differentiation in IM. To investigate the mechnism of H. pylori related IM, for establish the basement for the divide IM from the new point.MATERIALSThe whole materials was collected from gastric cancer high risk area of Zhuanghe city Liaoning province peoples . Detecting the expression of CDX2 in 285 cases. Detecting the expression of GST - πin 282 cases . Detecing the polymorphism of GSTP1 in 92 cases .METHODSThe subtypes of IM are classified by high - iron diamine /alcian blue pH2.5/periodic acid - Schiff (HID - ABpH 2.5 -PAS) method. The expression levels of GST - πwere, determined by two steps immunohistochemical method . H. pylori infection was confirmed or excluded in all patients by histological examination hematoxylin - eosin ( HE) , and enzyme - linked immunosorbent assay (ELISA) for anti - H. pylori immunoglobulin G(IgG). CagA H. pylori infection detecting with ELISA. The polymorphism of GSTPl were determined by RFLP method.RESUITSPaper11,The expression of CDX2 in normal gastric mucosa , IM and gastric cancerThe positive rates of CDX2 expression in IM and gastric cancer were significantly higher than normal gastric mucosa , where were all negative( P <0.01) . The positive rates of CDX2 expression of gastric cancer is lower than that of IM ( P <0.01). The positive rates of CDX2 expression in IM I, IM II, IM III were decreased in sequence, there was significantly difference between IM I and IM III subtype (P <0. 01) ; there was difference between IM II and IM III(P <0. 05 ) . The positive rate of CDX2 expression in IM I had significantly difference compared with gastric cancer group (P <0. 01) ; the positive rate of CDX2 expression in IM II had difference compared with gastric cancer group ( P < 0. 05) , while there were no difference between IM III and gastric cancer group. CDX2 was mainly located in IM cellular nucleus.2, The effection of H. pylori infection to the expression of CDX2The positive rates ofCDX2 H. pylori - negative groups IM were higher than H. pylori - npositive groups IM ( P > 0.05 )Paper 21,The expression of GST - πin normal gastric mucosa , IM and gastric cancerThe positive rates of GST - π expression in IM and gastric cancer were significantly higher than normal gastric mucosa , where were all negative ( P < 0.01). The positive rates of GST — π expression of gastric cancer is lower than that of IM(P <0.01). The positive rates of GST - πexpression in IM I, IM II , IM III were decreased in sequence, there was significantly difference between IM I and IM III ( P <0.01) ; there was difference between IM II and IM III (P <0. 05 ) . The positive rate of GST - πexpression in IM I had significantly difference compared with gastric cancer group ( P < 0. 01) ; the positive rate of GST -πexpression in IM II had difference compared with gastric cancer group (P <0. 05) , while there were no difference between IM III and gastric cancer group. GST — πwas mainly located in IM cellular plasma.2,The effection of H. pylori infection and CagA infection to the expression ofGST-πThe positive rates of GST — π in H. pylori - negative groups IM were higher than H. pylori - positive groups IM ( P < 0.05 ) ; the positive rate of GST - π in H. pylori - positive I, II, III subtype IM were respectively higher H. pylori -negative IMI, II, III. The positive rate of GST - πexpression in H. pylori - eradi-catived group were significantly higher than gastric cancer group ( P < 0. 01). The positive rate of GST - πexpression in CagA - negative group was high than Cag A positive group( P > 0.05 ).Paper 31 , Distribution of GSTP1 polymorphism in IM and subtype IMThe polymorphism of GSTP1 often more be found in IM than normal control group ( P < 0.05 ). The polymorphism of GSTP1 often more be found in IM II, III than IMI(P<0.05).2, The relationship between H. pylori infection and the distribution of GSTP1 polymorphism .The polymorphism of GSTP1 is also be found in H. pylori positive group than normal control group(P <0.05). In H. pylori positive group ,the polymorphism of GSTP1 is also be found in IM II,III than IM I(P <0.05).CONCLUSIONS1. The IM where no or low expression of CDX2, GST - π were poor differ-...
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