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目的:探讨胃癌及癌前病变中端粒酶逆转录酶(hTERT)基因和c-myc蛋白的表达及相互关系。 方法:以41例胃癌和25例相应非癌组织为研究对象,采用免疫组化和原位杂交方法检测c-myc蛋白、hTERT蛋白和hTERTmRNA,并对各指标阳性表达率和相关性进行比较分析。 结果:正常胃黏膜-肠型化生-异型增生-胃癌中,c-myc蛋白的阳性率分别为0,30％,53％,59％;hTERTmRNA的阳性率为10％,39％,67％,85％;hTERT蛋白为0,30％,60％,78％。三者在异型增生、胃癌中分别与正常组相比差异有显著性,而且肠化与胃癌组比较也分别具有显著性(P<0.05)。胃癌中,c-myc和hTERT蛋白的表达在低未分化、进展期、有淋巴结转移和浸润至浆膜层的肿瘤中显著增高(P<0.01～0.05)。而hTERTmRNA的表达仅与肿瘤分期有关。肠化、异型增生和胃癌三组中,c-myc和hTERTmRNA及hTERTmRNA和蛋白间分别具有显著性正相关(r_s=0.504～0.696,P<0.05)。 结论:c-myc和hTERT的过表达是胃癌发生中的早期事件,其表达水平随着胃癌恶性程度的增加而增加;c-myc在转录水平上激活hTERT的表达,可能是胃癌发生发展的重要阶段。
Objective: To investigate the expression and relationship of telomerase reverse transcriptase (hTERT) gene and c-myc protein in gastric cancer and precancerous lesions. Methods: Forty-one cases of gastric cancer and 25 cases of non-cancer tissues were studied. The c-myc protein, hTERT protein and hTERT mRNA were detected by immunohistochemistry and in situ hybridization. The positive expression rate and correlation of each marker were compared and analyzed. . Results: The positive rates of c-myc protein in normal gastric mucosa-intestinal metaplasia and dysplasia-gastric cancer were 0, 30%, 53% and 59%, respectively; the positive rates of hTERT mRNA were 10%, 39%, and 67%. , 85%; hTERT protein was 0, 30%, 60%, 78%. There were significant differences between the three groups in dysplasia and gastric cancer compared with the normal group, and the intestinal metaplasia and gastric cancer group also had significant differences (P<0.05). In gastric cancer, the expression of c-myc and hTERT protein was significantly increased in low undifferentiated, advanced stage, lymph node metastasis, and tumors infiltrating into serosa (P<0.01-0.05). The expression of hTERT mRNA is only related to tumor stage. In the three groups of intestinal metaplasia, dysplasia and gastric cancer, there was a significant positive correlation between c-myc and hTERT mRNA and hTERT mRNA and protein respectively (r_s=0.504-0.696, P<0.05). Conclusion: Overexpression of c-myc and hTERT is an early event in gastric cancer. The expression level of c-myc and hTERT increases with the increase of the degree of malignancy of gastric cancer. The expression of hTERT at the transcriptional level of c-myc may play an important role in the development of gastric cancer. stage.