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目的：研究幽门螺杆菌（H.pylori）感染胃癌患者胃粘膜病变中抑癌基因p53、p16和关键性凋亡调节基因bcl-2蛋白的表达，进一步探讨H.pylori在胃癌发生、发展过程中作用的分子机制。方法：胃镜检查及外科手术中取40例胃癌患者的癌组织和癌旁2cm处组织各2块，石蜡包埋，切片HE染色作病理诊断及免疫组化检测p53、p16及bcl．2蛋白的表达。Hpylori阳性由快速尿素酶试验结合病理染色／14C-尿素呼气试验确定。结果：40例胃癌患者中，HPylori阳性23例，阴性17例。P53阳性表达率在H.pylori阳性及阴性胃癌组织中无显著差异（P＞005）。H．Pylori阳性组慢性胃炎或肠化组织中p16的阳性表达率及表达强度均显著低于H.pylori阴性组（表达率：P＜0.05；表达强度：P＜0．001和P＜0.01）。而H.pylori阳性组肠化组织中bcl-2的阳性表达率及表达强度均显著高于H.pylori阴性组（P＜0.05）。结论：在胃癌发生的早期即存在较明显的p16基因表达低下与bcl-2基因过度表达，并与H.pylori感染有一定关系。p53基因过度表达是胃癌发展过程中较晚期的事件，与H．pylori感染无明显相关性。
Objective: To study the expression of p53, p16 and bcl-2 in gastric mucosal lesions of gastric cancer patients infected with Helicobacter pylori (H. pylori) and to further explore the role of H.pylori in the development and progression of gastric cancer The molecular mechanism of action. Methods: Gastroscopy and surgery were performed in 40 cases of gastric cancer and 2 cases of cancer adjacent to each other. Two sections were paraffin embedded and stained with HE for pathological diagnosis and immunohistochemical detection of p53, p16 and bcl. 2 protein expression. Hpylori positive was determined by a rapid urease assay in combination with a histological staining / 14 C-urea breath test. Results: Of 40 gastric cancer patients, 23 were positive for HPylori and 17 were negative. The positive expression rate of P53 in H.pylori positive and negative gastric cancer tissues showed no significant difference (P> 005). H. The positive rate and the expression of p16 in chronic gastritis or intestinal metaplasia were significantly lower in Pylori positive group than in H.pylori negative group (expression rate: P <0.05; expression intensity: P <0.001 and P <0.01). However, the positive rate and the expression of bcl-2 in intestinal mucosa of H.pylori-positive group were significantly higher than those in H.pylori-negative group (P <0.05). CONCLUSIONS: In the early stage of gastric cancer, there is a more obvious expression of p16 gene and bcl-2 gene overexpression, which is related to H.pylori infection. p53 gene overexpression is a more advanced event in the development of gastric cancer. No significant correlation between pylori infection.