论文部分内容阅读
目的探讨放大胃镜、增殖细胞核抗原(PCNA)、p53在胃黏膜癌前病变中的诊断价值。方法应用放大胃镜对180例病人进行检查,放大胃镜下做出实时诊断,取活组织分别送病理学检查和免疫组化法检测PCNA和p53的表达。放大胃镜下胃小凹分为A、B、C、D、E5型[1]。结果放大胃镜下B～E4种胃小凹形态肠上皮化生发生率差异有统计学意义(χ2=16.24,P<0.05),并且肠上皮化生的严重程度逐渐加重(相关系数=0.612,P<0.05):C～E3种胃小凹形态与不典型增生的严重程度关系密切(χ2=11.31,相关系数=0.637,P<0.05):B、C、D、E等4型胃小凹形态间PCNA和p53表达量差异有统计学意义(F=6.514,P<0.05)。结论放大胃镜下胃黏膜微细结构形态可反映病变程度的轻重,PCNA和p53是重要的胃癌标志物,随访E型胃小凹、高PCNA和p53表达的患者有助于早期发现胃癌。
Objective To investigate the diagnostic value of enlarging gastroscope, proliferating cell nuclear antigen (PCNA) and p53 in precancerous lesions of gastric mucosa. Methods 180 cases of patients were examined by enlarging endoscopy, and real-time diagnosis was performed under magnifying endoscopy. Pathological examination and immunohistochemistry were used to detect the expression of PCNA and p53. Enlarged gastroscopy under the fovea into A, B, C, D, E5 type [1]. Results There was a significant difference in the incidence of intestinal metaplasia between gastric biopsies of B ~ E under endoscopy (χ2 = 16.24, P <0.05), and the severity of intestinal metaplasia was gradually increased (correlation coefficient = 0.612, P (P <0.05). There was a close relationship between the morphology of gastric pits and the severity of atypical hyperplasia (χ2 = 11.31, correlation coefficient = 0.637, P <0.05) There was a significant difference between the expression of PCNA and p53 (F = 6.514, P <0.05). Conclusions Enlarging the morphology of gastric mucosa under endoscopy can reflect the degree of lesion. PCNA and p53 are important markers of gastric cancer. Follow-up of patients with E-type gastric cavity, high PCNA and p53 expression is helpful for the early detection of gastric cancer.