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目的探讨胃部细胞的代谢特点、异型增生与胃癌的关系以及胃癌生物学行为与乳酸脱氢酶（ＬＤＨ）同工酶的关系。方法应用酶细胞化学方法，观察５０例胃癌细胞ＬＤＨ同工酶的活性和分布。结果胃癌细胞ＬＤＨ总活性和Ｍ型ＬＤＨ明显高于主细胞、表面上皮和幽门腺上皮（Ｐ＜０００１），与异型增生上皮之间无显著性差异（Ｐ＞０２）。胃癌细胞Ｈ型ＬＤＨ低于主细胞、壁细胞和异型增生上皮（Ｐ＜００５），与表面上皮和幽门腺上皮之间无显著性差异（Ｐ＞００５）。胃癌细胞ＬＤＨ同工酶以Ｍ型为主。除分化型胃癌细胞Ｈ型ＬＤＨ阳性率高于未分化型胃癌（Ｐ＜００５）外，胃癌生物学行为与ＬＤＨ同工酶阳性率之间无明显关系（Ｐ＞００５）。结论胃癌细胞内ＬＤＨ及Ｍ型ＬＤＨ活性升高，同工酶以Ｍ型为主。Ｍ型ＬＤＨ升高可能与细胞增殖活性有关。Ｈ型ＬＤＨ可作为判断胃癌恶性程度的酶学指标。异型增生可能系正常胃粘膜与胃癌之间的一种交界性病变。
Objective To investigate the metabolic characteristics of gastric cells, the relationship between dysplasia and gastric cancer, and the relationship between biological behaviors of gastric cancer and lactate dehydrogenase (LDH) isoenzymes. Methods The activity and distribution of LDH isoenzymes in 50 gastric cancer cells were observed by enzymatic cytochemistry. RESULTS: The total activity of LDH and M-type LDH in gastric cancer cells were significantly higher than those in primary cells, surface epithelium, and pyloric gland epithelium (P<0.001), and there was no significant difference between dysplasia and epithelial dysplasia (P>02). The H-type LDH of gastric cancer cells was lower than that of main cells, parietal cells and dysplastic epithelium (P<0. 05), and there was no significant difference between surface epithelium and pyloric gland epithelium (P>005). The LDH isoenzymes of gastric cancer cells are mainly M-type. In addition to the positive rate of H-type LDH in differentiated gastric cancer cells was higher than that of undifferentiated gastric cancer (P<005), there was no significant relationship between the biological behavior of gastric cancer and the positive rate of LDH isoenzymes (P>005). Conclusion The activity of LDH and M-type LDH in gastric cancer cells is elevated, and the isoenzymes are mainly M-type. The increase in M-type LDH may be related to cell proliferation activity. H-LDH can be used as an enzymological indicator to judge the degree of malignancy of gastric cancer. Dysplasia may be a borderline lesion between normal gastric mucosa and gastric cancer.