The Expression Of CEA, C-erbB-2 And Ki67 Proteins In Simple Intestinal Metaplasia (SIM) And Atypical Intestinal Metaplasia (AIM) And Their Relationship To Gastric Adenocarcinoma

Objective:To study the expressions of CEA,c-erbB-2 and ki67 proteins in intestinal metaplasia and adenocarcinoma and explore their relationships.Methods:The specimens of 411 patients with intestinal metaplasia and 37 patients with gastric adenocarcinoma were collected from Jan 2005 to Dec 2006 in Department of Pathology,Qilu Hospital.Specimens of 53 cases with intestinal metaplasia and 37 cases with gastric adenocarcinoma were chosen for study.We classified 53 specimens with intestinal metaplasia into simple intestinal metaplasia(SIM) and atypical intestinal metaplasia(AIM) according morphology of epithelial cell.We also classified the IM into typeⅠ,ⅡandⅢaccording AB-PAS and HID-AB staining.Immunohistochemical EnVision method was used to detect the expression of CEA,c-erbB-2 and ki67 proteins in each type of IM and gastric adenocarcinoma. The relationships between gastric adenocarcinoma and each type of IM were analyses.SPSS 13.0 for Windows was utilized for statistical analysis.Results:27 cases of SIM according AB-PAS and HID-AB staining included 10 cases of type Ⅰ,14 cases of typeⅡand 3 cases of typeⅢ.26 cases of AIM included 17 cases of typeⅠ,3 cases of typeⅡand 6 cases of typeⅢ.The positive rates of CEA in SIM,AIM and gastric adenocarcinoma were 25.93%, 61.54%and 78.39%,respectively.The expression of CEA in gastric adenocarcinoma was significantly higher than SIM(P＜0.05).There was no significant difference between AIM and gastric adenocarcinoma(P＞0.05).The positive rates of CEA in typeⅠ,ⅡandⅢwere 37.04%,41.18%,66.67%.The expression of CEA in gastric adenocarcinoma was significantly higher than typeⅠandⅡ(P＜0.05).There was no significant difference between typeⅢand gastric adenocarcinoma(P＞0.05).The positive rates of c-erbB-2 in SIM,AIM and gastric adenocarcinoma were 33.33%, 65.38%and 59.46%,respectively.The expression of c-erbB-2 in gastric adenocarcinoma was significantly higher than SIM(P＜0.05).There was no significant difference between AIM and gastric adenocarcinoma(P＞0.05).The positive rates of c-erbB-2 in typeⅠ,ⅡandⅢwere 55.56%,47.06%,33.33%.The expression of c-erbB-2 in gastric adenocarcinoma was not significantly higher than typeⅠ,ⅡandⅢ(P＞0.05).The positive rates of Ki67 in SIM,AIM and gastric adenocarcinoma were 37.04%, 57.69%and 75.68%,respectively.The expression of Ki67 in gastric adenocarcinoma was significantly higher than SIM(P＜0.05).There was no significant difference between AIM and gastric adenocarcinoma(P＞0.05).The positive rates of Ki67 in typeⅠ,ⅡandⅢwere 59.30%,35.29%,44.44%.The expression of Ki67 in gastric adenocarcinoma was significantly higher than typeⅡ(P＜0.05).There was no significant difference between gastric adenocarcinoma and typeⅠorⅢ(P＞0.05).Conclusions:1.There was no significant difference of expressions of CEA,c-erbB-2 and ki67 proteins in AIM and gastric adenocarcinoma.It demonstrated that AIM was closely related to gastric adenocarcinoma in contrast with the SIM.2.The expression of CEA in three types of IM according AB-PAS and HID-AB staining showed that typeⅢwas closely related to gastric adenocarcinoma. Meanwhile,the expression of c-erbB-2 showed that all three types IM were closely related to gastric adenocarcinoma.However,the expression of ki67 in three types of IM showed that only typeⅡwas closely related to gastric adenocarcinoma.Therefore, classification of typeⅠ,ⅡandⅢaccording AB-PAS and HID-AB staining could not show specific relationship between gastric adenocarcinoma and typeⅠ,ⅡorⅢ.3.The classification of SIM and AIM according morphology of epithelial cell may be practical and easy to increase the early detection of gastric carcinoma,patients with AIM must be followed up closely.