| OBJECTIVEThe biological secimens of early gastric cancer were classified with Lauren-s classification method to intestinal-type and diffuse-type,and to analysis clinical characteristics and biological behavior of two types of gastric cancer;To evaluated mucosal height,number of glands,and the degree of intestinal metaplasia(Intestinal metaplasia,IM) of the background adjacent mucosal tissues of diffuse-type and intestinal-type early gastric cancer,and to explore the relationship between the situation of inflammation and the two types of early gastric cancer.To research the expression of Helicobacter pylori (Helicobacter Pylori,H.pylori) infection in adjacent mucosal tissues of diffuse-type and intestinal-type early gastric cancer,and to discuss its relationship with the pathology characteristics of the two types of early gastric cancer;To research the expression of promote apoptosis protein PDCD5 in early gastric cancer and the gastric mucosa adjacent to cancer, and to evaluate its possible effect in the diagnosis and prognosis of early gastric cancer.METHODSThe biological specimens of 65 cases of patients with early gastric cancer were collected from our hospital,which were undergo pathology diagnosis and clinical treatment.The cancer tissue biopsy after AB-PAS(Alcian blue-periodic acid sthiff, AB-PAS) staining,according to Laurens histological classification will be divided into intestinal-type and diffuse-type of early gastric.And to analysis the characteristics of clinical and biological behavior between the two types of early gastric cancer(including gender,age,location of tumor,gross type,tumor size,depth of invasion and lymph node metastasis);Early gastric paracarcinomatous mucosal heights measurements with Image-pro plus 6.0 image analysis software,while the number and the IM degree of paracarcinomatous mucosa gland were observed by an optical microscope.The H.pylori infection of paracarcinomatous mucosa was detected using Giemsa staining.The expressions of PDCD5 in early gastric cancer and paracarcinomatous mucosal were detected by immunohistochemistry(Envision method). These values were statistically compared with SPSS 19.0.RESULT1. The analysis of clinical data of 65 cases of patients with early gastric found that:(1) In the male patients,the intestinal-type of early gastric cancer were accounted for 48.7%,however the diffuse-type were accounted for 51.3%;In the female patients,the intestinal-type of early gastric cancer were accounted for 19.2%,however the diffuse-type were accounted for 80.8%.There was statistically significants in gender distribution of the two types of gastric cancer(P=0.016); (2)There was statistically significant of the age gap in the two types of early gastric cancer(P=0.003); (3) There were 13 patients with lymph node metastasis of the 65 patients, intestinal-type (1/24), diffuse-type (12/41), there was statistically significant between the two types (P =0.015).2. The average mucosal heights around early gastric cancer were lower in diffuse-type cases than intestinal-type cases(t=-3.112,P=0.003), besides the degree of IM is less frequently compared with intestinal cancer(t=-2.197,P=0.032).3. There was no difference of H.pylori infection in the two types of gastric paracarcinomatous mucosal(x2=3.183,P=0.074);There was statistically significant of H.pylori positive chronic active gastritis in the two types of gastric paracarcinomatous mucosal(x2=4.44,P=0.035).4. The expression of PDCD5 in different histologic types of early gastric cancer and the gastric mucosa adjacent to cancer findings:(1) There was statistically significant of the positive rates of PDCD5 in normal gastric mucosa,paracarcinomatous mucosa and early gastric cancer(P=0.002). (2) The PDCD5 positive expression rate were significantly lower in diffuse-type than intestinal-type of early gastric cancer (P=0.003).There was no difference of PDCD5 positive expression in the two types of gastric paracarcinomatous mucosal (P=0.361).CONCLUSIONThe diffuse-type gastric cancer was significantly associated with younger age,female preponderance and higher ratio of lymph node metastasis compared with intestinal-type gastric cancer.The diffuse-type gastric cancer has lower relationship with intestinal metaplasia,and the atrophic gastric without IM or H.pylori positive chronic active gastritis may be its precancerous lesions.The expression of PDCD5 was lower in early gastric cancer and mucosal inflammation tissue adjacent to carcinoma, wich indicated organizations have some carcinogenesis tendency and those have some relationship with histological classification of carcinoma.So it can be used for screening and judging prognosis of early gastric cancer. |
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