Relationship Between Helicobacter Pylori, Gst-Ï€ Protein, Runx3 Protein And Gastric Carcinoma

Objective:1.To study the infection of Helicobacter pylori,the expression of Gst-πprotein and Runx3 protein in gastric antral carcinoma, gastric antral ulcer and chronic atrophic antral gastritis.2. To investigate the association between Gst-πprotein,Runx3 protein and clinicopathologic characteristics in gastric antral carcinoma.3. To investigate the association between the infection of helicobacter pylori and the expression of Gst-πprotein,Runx3 protein.4. To study the association between different gastric mucosal lesions and different types of Epigastralgia in Chinese medicine.5. To study the association between the infection of helicobacter pylori and different types of Epigastralgia in Chinese medicine.Methods:1. Collected the patients' gastric mucosa specimens of inpatients and outpatients of digestive system department in Guangzhou Military General Hospital from March 2009 to March 2010, whose chief complaints were "epigastric pain".After pathological diagnosis of gastric mucosa biopsyed during gastroscopy, the patients were divided into three groups:gastric antral carcinoma group, gastric antral ulcer group and chronic atrophic antral gastritis group,40 cases for each group.2. The patients'chief complaints were "epigastric pain".They were diagnosed with "Epigastralgia", according to syndrome differentiation. The objects were divided into different types of Epigastralgia, according to the four diagnostic methods in traditional Chinese medicine.3. The Hp infection was unitedly measured by Giemsa special pathological dyeing method and carbon 14 breath test.4. Immunohistochemical method (Two Stage Method) was used to detect the expression of Gst-πprotein, Runx3 Protein.5. To analyze the datas by SPSS 16.0.Results:1. The Hp infection rate was spectively 57.5%,82.5%,45% in gastric antral carcinoma, gastric antral ulcer and chronic atrophic antral gastritis.Hp infection rate among the three groups were significantly different (x2= 12.338, P=0.002<0.05). The rate of Hp infection in gastric antral cancinoma was significantly lower than the gastric anral ulcer group, the difference was statistically significant (x2=5.952, P=0.015<0.0167); The rate of Hp infection in gastric anral ulcer was significantly higher than chronic atrophic antral gastritis group, the difference was statistically significant (x2=12.170, P=0.000<0.0167); There was no significant difference between gastric antral cancinoma and chronic atrophic antral gastritis (x2=1.251, P=0.263>0.0167).2. The Gst-πexpression rate was 85% in gastric antral carcinoma,60% in gastric antral ulcer and 55% in chronic atrophic antral gastritis. The statistical difference was significant (x2=9.300,P=0.01). There was significant difference between gastric antral cancinoma and gastric antral ulcer (x2=6.270, P=0.012<0.0167), so was gastric antral cancinoma and chronic atrophic antral gastritis (x2=8.571, P=0.003<0.0167). There was no significant difference between gastric antral ulcer and chronic atrophic antral gastritis (x2=0.205, P=0.651>0.0167)3.The positive degree of Gst-πin different gastric mucosal lesions: gastric antral cancinoma group was higher than other groups. The statistical difference was significant (x2=11.669, P=0.003)4. The expression of Runx3 in different gastric mucosal lesions:gastric antral carcinoma group was 35%, gastric antral ulcer group was 62.5%, chronic atrophic antral gastritis group was 70%. The statistical difference was significant (x2=11.017, P=0.004). Gastric antral cancinoma group was lower than other groups. There was significant difference between gastric antral cancinoma and gastric antral ulcer (x2=6.054, P=0.014<0.0167), so was gastric antral cancinoma and chronic atrophic antral gastritis (x2=9.825, P=0.002<0.0167). There was no significant difference between gastric antral ulcer and chronic atrophic antral gastritis (x2=0.503, P=0.478>0.0167).5. The positive degree of Runx3 in different gastric mucosal lesions: gastric antral cancinoma group was lower than other groups. The statistical difference was significant (x2=7.353, P=0.025<0.05)6. The Helicobacter pylori infection was positively correlated with the expression of Gst-π.The positive rate of Gst-πwas 75.7% in Hp-positive group, which was significantly higher than the positive rate of Gst-πin Hp-negative group (52.2%) (r=0.242, P=0.008<0.05)。7.The Helicobacter pylori infection was negative correlated with the expression of Runx3. The positive rate of Runx3 was 39.2% in Hp-positive group, which was significantly lower than the positive rate of Runx3 in Hp-negative group (82.7%), (r=-0.425, P=0.000<0.05)8. The correlation of Gst-πand clinicopathologic characteristics in gastric antral cancer:The expression of Gst-πwas no correlated with gastric cancer differentiated degree. The expression of Gst-πwas positively correlated with the TNM stages(r=0.336, P=0.034<0.05).9. The correlation of Runx3 and clinicopathologic characteristics in gastric antral cancer:The expression of Runx3 was no correlated with gastric cancer differentiated degree.The expression of Runx3 was negatively correlated with the TNM stages(r=-0.435, P=0.005<0.05).10. The expression of Gst-πwas negatively correlated with the expression of Runx3 (r=-0.309, P=0.001<0.05)11. The relevance between gastric antral carcinoma, gastric antral ulcer, chronic atrophic antral gastritis and different types of Epigastralgia:There was significant difference between different gastric mucosal lesions and different types of Epigastralgia(x2=26.053, P=0.004<0.05). The primary types of gastric antral carcinoma were "damp-heat in spleen and stomach" type and "weakness of spleen and stomach" type, accounting for 40%,25% respectively; The primary type of the gasric antral ulcer group was "damp-heat in spleen and stomach" type and "deficiency of stomach yin" type, accounting for 52.5%,15% respectively; The primary type of the chronic atrophic antral gastritis group was "incoordination between liver and stomach" type, accounting for 37.5%.12. The positive rate of Hp infection of different types of Epigastralgia: "damp-heat in spleen and stomach" type was 80.4%, which was significantly higher than other groups.The statistical difference was significant (x2= 19.379, P=0.002<0.05) Conclusion:Hp may be one of the factors of the gastric cancer, while the expressions of Gst-πand Runx3 protein play the important role in the development of gastric cancer. Comprehensive assessment of Gst-πprotein, Runx3 protein contributes to the high risk of early gastric cancer screening and prevention. The primary type of Epigastralgia in Chinese medicine is "damp-heat in spleen and stomach" type, which is accompanied by Hp and susceptible to gastric ulcer or gastric cancer. Helicobacter pylori can induce inflammation, regulating oncogenes and tumor suppressor genes, induction of abnormal epithelial proliferation and apoptosis and its metabolites, including some enzymes, toxins and proteins, which cause direct damagement to mucous and introduce diseases.It is advised that patients of this type should be gastroscopied and eliminated from the infection of Hp.