| [Objictive]Gastric carcinoma is one of the most common malignancies in our nation. It is not entirely clear for the pathogenesis of gastric carcinoma. DNA mismatch repair genes and apoptosis-associated genes are involved in the histogenesis and development of human malignancies. In the present study, expression of Msh2, bcl-2 and bax in gastric carcinoma was investigated. The relationship of Msh2 expression to bcl-2 and bax in gastric carcinoma was analysed. The association of their expression with clinical pathological factors and prognosis outcome was explored.[Methods]63 specimens of gastric carcinoma with well-controlled follow up from 1989 - 1994 year were obtained from the Second Affiliated Hospital of Zhejiang University School of Medcine. Immunohistochemistry was carried out to detect the expression of bcl-2 bax and Msh2. The relationship among them was analysed with chi-square test and kendall tau correlation test by SPSS for Windows 10.0 software. With Kaplan-Meier method , Log-rank test and Cox proportional-hazards model, we achieved the survival rate results of computerized analysis of gastric carcinoma. [Results]1 Effect of clinicopathologic characters upon survival rates of patients with gastric carcinomaTNM grade had obvious relation to survival rate(p<0.05). Patient ages at diagnosis , gender the degrade of differentiation , and the typing of Lauren had no obvious relation to prognosis(p>0.05).2 Immunohistochemistry of bcl-2 bax and Msh2 protein.In 63 specimens of gastric carcinoma the positive rate of bcl-2,bax and Msh2 was 75 % ( 47/63 ), 73 % ( 46/63 ), 49 % ( 31/63 ) respectively. The expression level of bcl-2 in male patients was significantly higher than that in female (p<0.05). The expression level of bax in male patients and Lauren' I type was significantly higher than that in female andLauren' II type (p<0.01). The expression level of Msh2 had no significant relation to clinicopathologic characters of gastric carcinoma. No significant difference of survival rate was observed when bcl-2 or Msh2 expressed in different level(p>0.05). The survival rate in bax low expression group was higher than that in the high group(p=0.05), and when surviving days of patients with gastric carcinoma were over 1000 days ,survival rates in the bax high expression group had obviously descended.3 The relationship among bcl-2 , bax and Msh2 expressionThere was significant relationship between bax and bcl-2 expression(p<0.05). When the expression level of bax was higher , the level of bcl-2 was higher too. The relationship between bax and Msh2 expression existed in gastric carcinoma(p<0.05). No significant relationship between bcl-2 and Msh2 expression was observed(p>0.05). When Msh2 expression level was negative, mild positive moderate positive and strong positive , the expression value of bcl-2 was 5.84 5.42, 5.00, 5.50(p>0.05). But with the quadratic curve we found that higher the Msh2 expression was ,lower the bcl-2 was.4 The Cox proportional-hazards modelIn Cox model TNM stages, Lauren type and expression of Msh2 were independent risk factors. According to the relative risk of TNM stages, Lauren type, Msh2 expression in Cox model , we established aprognostic index. The range of prognostic index was 5-10 , 5 year survival rate varied from 100 - 0% , and there was trend of decline in survival rate when the prognostic index was increased(p<0.01). The 5-year survival rate of patients scored 5 - 7 was 83% , that of patients scored 8 - 10 was 30%(p<0.01). [Conclusions]1 bcl-2 and bax expression level are higher in male patients with grastric carcinoma than those in female. Bax expression level is higher in Lauren type I than that in Lauren type II. We can not estimate prognosis with bcl-2 or bax isolatively.2 There are significant correlation between bax and bcl-2 exoression , or between bax and Msh2 expression. Their expression level in gastri...
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