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目的检测胃粘膜肠化生和异型增生病变部位Ｐ２１和Ｐ５３蛋白表达与胃癌发生的关系．方法内窥镜及病理学证实为胃粘膜肠化生者４４例，男２６例，女１８例，平均年龄４７５岁．异型增生者１４例，男９例，女５例，平均年龄６４５岁．粘液组化将肠化生分型，免疫组化测定Ｐ２１及Ｐ５３蛋白表达．结果Ⅱｂ型肠化生Ｐ２１及Ｐ５３蛋白阳性率分别为７００％和３００％，均显著高于Ⅰｂ型肠化生（２５８％和６４％，Ｐ＜００１）．异型增生Ｐ２１及Ｐ５３阳性率为４２８％和２８５％，高于肠化组３４％和１１８％．Ⅱｂ型肠化异型增生Ｐ２１和Ｐ５３阳性率为６２５％和３７５％，也高于Ⅰｂ型肠化异型增生组１６６％和１６６％．结论分泌非中性粘液的Ⅱｂ型肠化异型增生带有更多与胃癌相同的生物学性状，可能与胃癌的发生关系密切．
Objective To detect the relationship between the expression of P21 and P53 proteins and the occurrence of gastric carcinoma in gastric metaplasia and dysplasia. Methods Endoscopy and pathology confirmed 44 cases of intestinal metaplasia of gastric mucosa, 26 males and 18 females, with an average age of 47 to 5 years old. Abnormal hyperplasia in 14 cases, 9 males and 5 females, the average age of 64 5 years old. Mucinous histochemical classification of intestinal metaplasia, immunohistochemical determination of P21 and P53 protein expression. Results The positive rates of P21 and P53 protein in type IIb intestinal metaplasia were 70.0% and 30.0%, respectively, which were significantly higher than that of type Ib (25.8% and 6.4%, P<0. 01). . The positive rates of dysplasia P21 and P53 were 42.8% and 28.5%, respectively, which were higher than those in the intestinal metaplasia group (34% and 11.8%). The positive rate of P21 and P53 in type IIb intestinal dysplasia was 62.5% and 37.5%, which was also higher than that in type Ib intestinal dysplasia (16.6% and 16.6%, respectively). Conclusion Type IIb intestinal dysplasia secreting non-neutral mucus has more biological characteristics than gastric carcinoma, and may be closely related to the occurrence of gastric cancer.