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目的 通过研究胃粘膜中S 10 0 +,HLA DR+,CD4 +和CD8+产物的表达情况 ,以了解树突状细胞 (DC)在胃粘膜免疫中的作用。方法 胃癌 ( 176例 )、慢性萎缩性胃炎 ( 4 1例 )、不典型增生 ( 15例 )、肠上皮化生 ( 2 7例 )和正常对照组 ( 10例 )共 2 69例 ,采用HE染色、S P免疫酶标抗体组化染色法与图像分析技术相结合 ,观察胃粘膜中S 10 0 +,HLA DR+,CD4 +和CD8+细胞数量、平均面积和平均吸光度的变化。结果 胃癌患者胃粘膜中S 10 0 +,HLA DR+细胞数量明显多于正常胃粘膜 (P <0 .0 5) ;CD4 +细胞及其平均吸光度显著减少 (P <0 .0 1) ;CD8+细胞数量、面积及其平均吸光度略有减少 ,但与正常组比较差异不显著 (P >0 .0 5) ;CD4 + CD8+比值为 0 .65,显著低于正常胃粘膜 (P <0 .0 1)。慢性萎缩性胃炎、肠上皮化生和不典型增生胃粘膜中S 10 0 +、HLA DR+细胞数量显著增加 (P <0 .0 1) ;CD8+细胞数量均明显高于正常胃粘膜 (P <0 .0 5) ;CD4 + CD8+比值分别为 0 .81,0 .59,0 .56,均显著低于正常胃粘膜 (P <0 .0 5)。结论 癌前状态胃粘膜中DC数量显著增多 ,功能增强 ;而胃癌患者胃粘膜中DC数量随分化程度的降低而减少。胃粘膜中DC细胞功能的抑制是导致胃粘膜免疫功能低下和癌前状态发生癌变的重要原因之一。
Objective To investigate the role of dendritic cells (DCs) in gastric mucosal immunity by studying the expression of S 10 0 +, HLA DR +, CD4 + and CD8 + in gastric mucosa. Methods A total of 269 cases of gastric cancer (176 cases), chronic atrophic gastritis (41 cases), atypical hyperplasia (15 cases), intestinal metaplasia (27 cases) and normal control group (10 cases) SP immunohistochemical staining and image analysis were used to observe the changes of S 10 0 +, HLA DR +, CD4 + and CD8 + cells in the gastric mucosa, the average area and the average absorbance. Results The number of S 10 0 + and HLA DR + cells in gastric mucosa of gastric cancer patients was significantly higher than that in normal gastric mucosa (P <0.05). The mean absorbance of CD4 + cells was significantly decreased (P <0.01) The number, area and average absorbance slightly decreased, but there was no significant difference compared with the normal group (P> 0.05); the ratio of CD4 + CD8 + was 0.65, which was significantly lower than that of the normal gastric mucosa ). The numbers of S 10 0+ and HLA DR + cells in chronic atrophic gastritis, intestinal metaplasia and atypical hyperplasia gastric mucosa were significantly increased (P <0.01), and the number of CD8 + cells was significantly higher than that in normal gastric mucosa .0 5). The ratio of CD4 + CD8 + was 0.81,0.59,0.56 respectively, which was significantly lower than that of normal gastric mucosa (P <0.05). Conclusion The number of DCs in gastric mucosa of precancerous lesions increased significantly and the function of gastric mucosa was enhanced. However, the number of DC in gastric mucosa of gastric cancer decreased with the decreasing of differentiation degree. Inhibition of DC cell function in gastric mucosa is one of the important causes of gastric mucosal immune dysfunction and carcinogenesis of precancerous conditions.