Ki-67表达及幽门螺杆菌感染在阿司匹林相关性胃黏膜病变中的作用

摘要

目的 探讨Ki-67表达及幽门螺杆菌(Helicobacter pylori,Hpylori)在阿司匹林相关性胃黏膜病变中的作用.方法 本组阿司匹林相关性胃黏膜病变患者共136例,根据胃镜下表现分为出血组、溃疡组和胃炎组；所有患者均应用快速尿素酶试验检测、病理组织学Giemsa染色及13C尿素呼气试验将136例阿司匹林相关性胃黏膜病变患者分为H.pylori感染阳性组和阴性组,应用免疫组织化学染色对各组病变的增殖细胞核抗原Ki-67表达进行检测.结果 在正常胃黏膜上皮组织Ki-67无表达或呈弱阳性表达,平均染色积分为0.125±0.354.在阿司匹林相关性胃黏膜病变中,出血组胃黏膜上皮组织Ki-67平均染色积分为3.916±1.676；溃疡组胃黏膜上皮组织Ki-67平均染色积分为2.174±1.527；胃炎组胃黏膜上皮组织Ki-67平均染色积分为1.394±0.899.出血组胃黏膜上皮组织Ki-67平均染色积分显著高于溃疡组及胃炎组(P＜0.05).H.pylori感染阳性组胃黏膜上皮组织Ki-67平均染色积分为2.275±1.511,H.pylori感染阴性组胃黏膜上皮组织Ki-67平均染色积分为1.588±1.698.H.pylori感染阳性组胃黏膜上皮组织Ki-67染色积分明显高于H.pylori感染阴性组(P＜0.05).结论 阿司匹林相关性胃黏膜病变组织中,阿司匹林和H.pylori均可导致胃黏膜的损伤,促进胃黏膜上皮细胞增殖.%Objective To explore the effects of Ki-67 expression and Helicobacter pylori (H. pylori) in aspirin associated gastric mucosa injury diseases. Methods According to the result of gastroscopic, 136 patients with aspirin associated gastric mucosa injury diseases were divided into three groups: bleeding group, ulcer group and gastritis group. All patients were detected with rapid urease test (RUT) , Giemsa stain and C -Urease breath test (13C -UBT). According to the results of above tests, the patients were divided into H. pylori infection group and H. pylori, non-infection group. The expression of Ki-67 protein was examined in 136 patients with aspirin associated gastric mucosa injury diseases samples by immunohistochemical technique. Results Immunohistochemical stain scores of Ki-67 in normal gastric mucosa was 0. 125 ±0.354. There were 3.916 ±1.676, 2. 174 ± 1.527 and 1.394 ±0.899 in immunohistochemical stain scores in bleeding group, ulcer group and gastritis group, respectively. Compared with ulcer group and gastritis group, significant elevated of Ki-67 expression was shown in bleeding group ( P < 0. 05 ). The expression of Ki-67 in the H. pylori infection group was significantly higher than that in the H. pylori non-infection group with immunohistochemical stain scores of 2. 275 ±1.511 and 1. 588 ± 1.698, respectively ( P < 0. 05 ) . Conclusion Both H. pylori infection and aspirin participated in gastric mucosa injury are associated with proliferation of gastric epithelial cells in aspirin associated gastric mucosa injury diseases.