| IntroductionThe cancerization of gastric mucosa is a chronic pathological process which has more steps and more stages , while Correa generalize and has a conclusion , that is , normal gastric mucosa to superficial gastritis to atrophic gastritis to atypical hyperplasia and to gastric carcinoma. At present , gastric carcinoma is the disease with the unclear pathology , while it is difficult to prevent the invasion of the nosogenesis and so to receive the first level prevention . So it is important to screen the high risk crowd and so to diagnosis and treat the gastric precancerous patients. Recently, along with the investigation of tumor marker ,systemic examine the level of the tumor marker during the gastric mucosa cancerization process has become the important point in the gastric cancinoma diagnosis and in the pathology.Gastrin is one of the gastric intestinal hormone which identified by public attention . Gastric Gene orientate in g region of chromosome 17 , which is composed of 4.1kb;and G cell which locate in the gastric antrum and near end of duodenum is the main location for the gastrin synthesis and secretion . The gastrin secretion methods include endocrine ,paracrine and cavity secretion, imido - Gastric is the main form for the gastric existence , which include two kinds of molecules, those are G -17 and G - 34 . However , G -17 account for 80% -90% , which is the gastrin main form in the gastric antrum and has physiology physical function overall , generally that is so - called the Gastrin . The main physical function of Gastrin includes accelerating parietal cell secretion acid , increasing gastric mucosa blood circulation , promoting mucosal epithelium growth , speeding gastric mucosa repairment and taking part in the gastic muco-sa inflammation reaction and so on . Recently , some investigation pointed out that the gastrin is one of the main factors for the gastric mucosa canceration , which main manifestation includes promoting cell proliferation and differentiation , inhibiting tumor cell apoptosis , accelerating tumor cell infiltration and cooperation with ori - oxydase - 2 . Drawing our attention , during the gastric mucosa canceration process , gastrin not only exert its action in the changes of serum level but also provide its possibility for the judgment and inspection in different stages of canceration , and even for the gastric carcinoma early stage diagnosis . On the other hand , since gastrin synthesis in the G cell and release in the blood , so the examination the serum gastrin level and analysis result becomes the important methods for the gastrin studies and their relationships. As everyone knows that serum gastrin level has complicated relations with the quantity of the G cells and its functions. However , the synthesis and secretion of gastrin can be affected by some factors such as ,ages , foods , medicines , secretion methods , physical state , the location of the disease and , the location of disease HP infection and so on , therefore , serum gastric level is not the real reflection of gastric mucosa . At present , there are some many investigations and reports about gastrin , however severely exist results disagreement and standpoints difference , which includes , lacking system and dynamic and too small amount of samples, and unevaluated the value of the gastrin protein in the gastric carcinoma, and so on . While , so far , the relationship during the affect factors of the gastrin and the serum gastrin level in the gastric mucosa cancerization and the gastrin present state is not be reported.ObjectiveTo explore the gastric protein presentation and serum gastrin level affect factors such as gastric protein present law , gender , ages , disease location , disease style and HP infection and so on. , and to explore the value in the gastric protein state presentation and serum gastric level in gastric carcinoma;uncovered the relationship between gastric protein state present and changes of the serum gastrin level and the function in gastrin during the gastric mucosa carceriza-tion , according to the observation during the gastric mucosa changes in different stages of gastric disease and according to the examination of the serum gastric and to the comparison of gastric protein state presentation to the serum gastric level.MethodsSerum gastrin level and HP antibody level can be detected by ELISA . Gas-trin protein can be observed by means of immunohistochemistry methods , HE staining then take part in pathology examination . 3906 cases come from Zhuang He Liaoning gastric carcinoma high risk region . Then Chinese Medical University s first clinical hospital and tumor hospital Liaoning province endoscope center received these patients and partly surgical patient . During the 3906 cases serum samples , there are 2946 cases have disease locations data , there are 3805 cases have HP infection through the serum antibody examination and the histology examination , during the samples serum and gastric mucosa tissues including the normal gastric mucosa 117 cases and 40 cases , mild chronic superficial gastritis 2754 cases and 80 cases, Gastric ulcer 413cases and 52 cases , chronic superficial gastritis with metaplasia 395 cases and 108 cases , atypical hyperplesia 6leases and 63 cases, gastric carcinoma 166 cases and 88cases.. Above all , the differentiation between the groups gender and ages have no statistic significance .Results1. In the process of the normal gastric mucosa via superficial gastritis to gastric ulcer to atrophic gastritis to gastric mucosa atypical hyperplasia to gastric cancer , the serum gastrin level increase progressively (p <0.05) in the superficial gastritis, From the gastric ulcer to gastric atrophic gastritis ,gastrin positive cells decrease significance ( p <0.01). From the atrophic gastritis to atypical hyperplasia to gastric cancer, gastrin positive cells increase significance(p <0. 01). Gastrin positive cells in the atrophic gastritis decrease than the othergroups. (p <0.05 or 0.01 or 0.000) , Gastrin positive cells in the atypical hyperplasia are lesser than the superficial gastritis ( p < 0. 05 ) , compare with the normal gastric mucosa, gastric ulcer and gastric cancer , there are no statistic significance .2. compare the serum gastrin level of male guoup to the female ones there is no statistic sigificance. Older than 60 years have higher serum gastrin level than younger than 40 years group ,40 -49 years group and 50 -59 years group. ( p <0. 05 or 0.000 and 0.005 ). The serum gastrin level in the gastric antrum is higher than gastric body disease group . (p <0. 000). The serum gastrin level in the Superficial gastritis , gastric ulcer , atrophic gastritis and gastric mucosa atypical hyperplasia is higher than normal gastric mucosa . (p<0.001orO. 000 and 0.005 ). The serum gastrin level in the mucosa atypical hyperplasia is higher than Superficial gastritis, atrophic gastritis and gastric carcinoma, (p <0.01 or 0.05 and 0. 000). The serum gastrin level in the gastric cancer is higher than Superficial gastritis, atrophic gastritis and gastric mucosa atypical hyperplasia (p <0.05 or 0.000) ,while compare with the normal mucosa there is no statistic significance.3. In the process of the normal gastric mucosa via superficial gastritis to gastric ulcer to atrophic gastritis to gastric mucosa atypical hyperplasic to gastric cancer , the number of the gastrin positive cells in the superficial gastritis is higher obveriously. ( p < 0. 005 ) , from the gastric mucosa erosion to atrophic gastritis, Gastrin male cell quantity obviously lower, and from the gastric mucosa atypical hyperplasia to gastric cancer, the quantity of the gastrin positive cells obviously inceased. From the normal gastric mucosa to the gastric mucosa erosion and ulcer , the serum gastrin level increased gradually . from the gastric mucosa erosion and ulcer to gastric cancer , the serum gastrin level decreased gradually . Among them the the serum gastrin level of the gastric mucosa erosion and ulcer is higher than normal gastric mucosa he gastric atrophic gastritis ( p < 0. 05) , the serum gastrin level of the gastric mucosa erosion and ulcer is higher than gastric atrophic gastritis and gastric carcinoma .Conclusion1. In the process of gastric mucosa carcinomatous change, the expression of gastrin protein present the fluctantlly changes . The gastrin protein presentation abnormal and nourish affection can increase the sensitivity of the gastric mucosa epithelium , and promote the growth and the amplification of the malignant cells , gastrin protein has an important value for the atrophic gastritis histology diagnosis.2. The different stages before the gastric carcinoma can increase the gastrin level , during the different stages before the gastric carcinoma the serum gastrin level along with the development of disease can be increased gradually , and become decrease to the cancer stage . Higher serum gastrin level is a sign for the precancerous lesion, the serum gastrin level is a good biology marker to differentiate the begin and Malignant disease. After the 60 years, the gastrin level of the old people becomes increased . The location of the gastric disease is the important factors for the serum gastrin level . HP infection can increase the serum gastrin level.3. During the early stage and later stage of the gastric mucosa cancerization , gastrin presentation separate with the serum gastrin and during the middle stage of the gastric mucosa cancerization , gastrin presentation paralle with the serum gastrin level . Gastrin secretion forms maybe the main reason for the dynamic changes.
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