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背景与目的:大约有10%的胃癌组织EB病毒(Epstein-Barrvirus,EBV阳性,但EBV在胃癌发生发展中的作用尚不明确。本研究检测Fas、FasL在EBV相关胃癌(EBV-associated gastric carcinoma,EBVaGC)中的表达,及其与肿瘤细胞和肿瘤浸润淋巴细胞(tumor infiltrating lymphocyte,TIL)凋亡的相互关系。方法:采用免疫组织化学方法检测49例EBVaGC、20例EBV阴性胃癌(EBV-negative gastric carcinoma,EBVnGC)以及12例正常胃黏膜中Fas、FasL的表达,并采用TUNEL技术检测细胞凋亡指数(apoptosis index,AI)。结果:12例正常胃黏膜和69例胃癌组织的Fas阳性率分别为91.7%和76.8%,FasL阳性率分别为16.7%和58.0%,差异有统计学意义(P<0.05);Fas在EBVaGC和EBVnGC组织中的阳性率分别为71.4%和90.0%,差异无统计学意义(P>0.05)。FasL在EBVaGC和EBVnGC组织中的阳性率分别为63.2%和45.0%,差异有统计学意义(P<0.05),且在弥漫型中的表达高于肠型(P=0.015);EBVaGC肿瘤细胞AI显著低于EBVnGC(P=0.002);TIL在EBVaGC的数量和AI均较EBVnGC高(P<0.05),且TIL的AI值与肿瘤细胞FasL表达呈正相关(r=0.237,P=0.028)。结论:EBVaGC中FasL蛋白表达的上调及TIL凋亡的降低有利于肿瘤细胞逃避机体免疫监视,为肿瘤的发生发展创造条件。
BACKGROUND & OBJECTIVE: Epstein-Barr virus (Epstein-Barr virus) is an effective marker of EBV-associated gastric carcinoma (EBV) in about 10% of gastric cancer tissues, but the role of EBV in the development of gastric cancer is unclear. , EBVaGC) and its relationship with the apoptosis of tumor cells and tumor infiltrating lymphocytes (TILs) .Methods: Immunohistochemistry was used to detect the expression of EBVaGC in 49 cases, EBV- negative gastric carcinoma (EBVnGC), 12 normal gastric mucosa and 12 normal gastric mucosa.Results: Fas positive in 12 cases of normal gastric mucosa and 69 cases of gastric cancer tissues were detected by TUNEL technique.Results: The positive rates of FasL were 91.7% and 76.8%, respectively. The positive rates of FasL were 16.7% and 58.0%, respectively, with significant difference (P <0.05). The positive rates of Fas in EBVaGC and EBVnGC were 71.4% and 90.0% The positive rates of FasL in EBVaGC and EBVnGC tissues were 63.2% and 45.0%, respectively, with significant difference (P <0.05), and their expression in diffuse type was higher than that in intestinal type (P = 0.015). The AI of EBVaGC tumor cells was significant (P = 0.002). The number and AI of TIL in EBVaGC were higher than EBVnGC (P <0.05), and the AI of TIL was positively correlated with the expression of FasL in tumor cells (r = 0.237, P = 0.028) .Conclusion: EBVaGC The up-regulation of FasL protein expression and the decrease of TIL apoptosis are favorable for tumor cells to evade the immune surveillance and create conditions for the occurrence and development of tumors.