| Objective:.To detect the expression of P53, Ki67, MUC2, PCNA in chronic gastritis, dysplasia and cancer tissues by immunohistochemistry to analyze the differential expression and evaluate the clinical diagnostic value.Methods:We collected 108 samples in the People's Hospital of Jiuquan City including 27 cases of gastric cancer,30 cases of chronic gastritis,32 cases of low-grade intraepithelial neoplasia and 19 cases of high-grade intraepithelial neoplasia. Immunohistochemisty staining of P53, Ki67, MUC2. PCNA was performed on four groups of total 108 cases.Results:1. Expression of P53 in all groupsThe positive expression rate of P53 in chronic gastritis, low-grade and high-grade intraepithelial neoplasia was increasing (20%,46.9%, 84.2%) and the expression intensity also showed an increasing trend. P53 expression between the groups was statistically significant (H=34.079,P=0.000). P53 expression was statistically significant in chronic gastritis and intraepithelial high-grade groups (x2=10.61, P<0.05), chronic gastritis and gastric cancer groups (x2=14.97,P<0.05) and low-grade intraepithelial neoplasia and cancer groups (x2=12.94, P<0.05). However, P53 expression in gastric cancer and high-grade intraepithelial neoplasia groups showed no statistical difference.2. Expression of MUC2 in all groupsThe positive expression rate of MUC2 in chronic gastritis, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia increased gradually (20%,56.3%,73.7%), and the expression intensity also showed an increasing trend. MUC2 expression was significantly different (x2=7.881, P<0.05). Pairwise comparisons showed that MUC2 in high-grade and low-grade intraepithelial neoplasia groups was significantly higher than in chronic gastritis group (x2=7.99, P<0.05; x2=13.45,P<0.05).Compared with high-grade intraepithelial neoplasia group, MUC2 positive expression rate decreased in gastric cancer group, however, there was no significant difference with other groups.3. Expression of Ki67 in all groupsThe positive expression of Ki67 in chronic gastritis, low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia and gastric cancer was significantly increased (20%,25%,63.2%,88.9%), and with the disease increased, strong expression was significantly increased. Ki67 expression was statistically significant (H=20.203, P<0.05). Pairwise comparisons showed that Ki67 expression was statistically significant in chronic gastritis and high-grade intraepithelial neoplasia groups (x2=9.323,P<0.05), chronic gastritis and gastric cancer groups (X2=27.050 P<0.05), low-grade and high-grade intraepithelial neoplasia groups (x2=7.282, P P<0.05), and low-grade intraepithelial neoplasia and cancer groups (x2=24.083, P<0.05). Ki67 in gastric cancer and high-grade intraepithelial neoplasia groups showed no statistical difference (x2=0.921, P>0.05).4. Expression of PCNA in all groupsThe expression of PCNA was significantly increased (40%,68.8%, 94.7%,100%) in chronic gastritis, low-grade intraepithelial neoplasia and high-grade prostatic intraepithelial neoplasia. With the disease increased, strong expression was significantly increased (H= 17.137, P<0.05). PCNA expression was statistically significant in chronic gastritis and intraepithelial high-grade groups (x2=12.56, P<0.05), chronic gastritis and gastric cancer groups (x2=25.13,P<0.05), low-grade intraepithelial neoplasia and cancer groups (x2=16.35,P<0.05. PCNA in gastric cancer and high-grade intraepithelial neoplasia groups showed no statistical difference (x2=0.23,P>0.05. Low-grade and high-grade intraepithelial neoplasia groups showed no statistical difference (x =6.99, P>0.05)5. Abnormal expression of PCNA and Ki67Abnormal expression of PCNA and Ki67 was in the increasing number and changing scope. PCNA and Ki67 were also expressed in cases of chronic gastritis, although the expression rate was lower than in intraepithelial neoplasia and cancer groups, and the expression was mainly in the mucosa basal layer. In intraepithelial neoplasia group, the position of expression of PCNA and Ki67 moved forward and the width of expression increased with the disease aggravated. In gastric cancer group, the expression exhibited full-thickness mucosa. and aggregated the tumor edge.6,Sensitivity and specificity of P53, muc2, ki67, PCAN for diagnosis of gastric cancerSensitivity of P53, muc2, ki67, PCAN for the diagnosis of gastric cancer was 77.8%,44.4%,88.9%,100%, and specificity was 59.5%,53.4%, 76.2%,38.1%.7. The value of combined detection of P53, PCNA and Ki67 in gastric carcinoma.The effect of combined detection of P53, pcna,and Ki67 in Gastric carcinoma by McNemar Test, P>0.05.Conclusion:1. In cancer and/or high-grade intraepithelial neoplasia groups expression of P53, Ki67, PCNA, MUC2 was significantly higher, confirming an important role of P53, Ki67, PCNA and MUC2 in.gastric cancer. 2. MUC2 expression increased in the intraepithelial neoplasia, confirming a close relationship of coexistence between intraepithelial neoplasia and intestinal metaplasia. It can be seen that adenocarcinoma is a gradual developing process from normal mucosa-chronic inflammation-IM-IN-carcinogenesis. Clue of the high expression of MUC2 may still be one of an important predictors of potential cancer.3,Both PCNA and Ki67 are proliferation indexes, but they are not related. Ki67 and PCNA in chronic gastritis, low-grade and high-grade intraepithelial neoplasia, and gastric cancer were expressed, and the positive rate increased gradually, reflecting the change of cell proliferation in the carcinogenesis of gastric epithelial cells, also confirming gastric cancer is a gradual process of development. Accordingly, PCNA and Ki67 are supposed to be important indicators to cancer. The abnormal expression of. PCNA and Ki67 not only shown in the increasing positive rates and staining intensity, but also in the gradual widening and forward scope. Therefor, criteria should not be confined to positive rate and staining intensity, instead, more excellent criteria should be achieved by further research from the expression of location and scope.4,MUC2 had poor specificity and sensitivity compared with PCAN, ki67and P53 in evaluating the value of accessory diagnosis. PCNA had a higher sensitivity, but poor specificity. Both specificity and sensitivity for Ki67 were relatively good, then P53 followed. Detection of Ki67 or P53 had a higher value when used for diagnosis for gastric cancer. The effect of combined detection had no significant difference, show that the combined detections had similar effect. |
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