| [Objective] To study the expression of Bcl-2 and Bax protein and explore the relationship between them and apoptosis in gastric carcinoma and precancerous lesions .and to investigate action of apoptosis in gastric carcinogenesis by study the relationship between apoptosis and proliferation in gastric cancer.[Methods] TUNEL method was used to detect apoptosis and immunohistochemical staining method was used to detect the expression of Bcl-2,Bax protein and Ki-67 in 70 chronic gastritis, 49 intestinal metaplasia , 64 dysplasia and 81 gastric carcinoma.[Results] The positive incidence of Bcl-2 and Bax was the highest in severe dysplasia, The positive incidence of Bcl-2 and Bax was higher in intestinal metaplasia and dysplasia than chronic gastritis and gastric carcinoma. During the process of evolvement from chronic gastritis to intestinal metaplasia then to dysplasia, apoptosis indexes gradually raises up to mid-high dysplasia, which reaches the highest point, then it begins to fall down .when it reaches gastric carcinoma ,that is the lowest point. There were negative correlation between the expression of Bcl-2 and apoptosis. In well and moderately differentiated adenocarcinomas the apoptotic indexes(AI)was significantly higher than poorly differentiated adenocarcinomas.The difference of AI was remarkably between well and moderately differentiated adenocarcinomas and poorly differentiated adenocarcinomas and signet-ring cell carcinomas, poorly differentiated adenocarcinomas and mucinous adenocaecinomas, signet-ring cell carcinomas and mucinous adenocarcinomas. [Conclusion] The expression of Bcl-2 may be a early behavior in the gastric carcinogenesis .Bax had antagonistic effect to Bcl-2, both of them were decided whether cells will be apoptosis. The poorly differentiated gastric carcinomas have an escape apoptosis mechanism.Apoptosis inhibited may exert important role in invasion and metastasis of gastric carcinomas.
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