| Objective: Observe pathological changes of gastric mucosa? Livin?Smac/DIABLO and Caspase-3 expression levels in patients with precancerous lesion of chronic atrophic gastritis, explore the correlation of turbidity toxin intrinsic syndrome and pathological changes, Livin?Smac/DIABLO and Caspase-3 in patients with precancerous lesion,to provides a scientific basis for clinical application of turbidity toxin theory.Detection in serum and gastric mucosal tissue expression of Livin?Smac/DIABLO?Caspase-3,and analysis of their correlation,to discuss their interaction in gastric precancerous lesions of the occurrence and development in the process.Methods:1 Collected 90 cases in May 2015-December 2015 in Hebei province hospital outpatient and ward patients clearly diagnosed CAG.According to the Chinese medicine new medicine clinical research guiding principles of diagnostic criteria to dialectical analysis of clinic patients,the satisfactory patients were divided into three groups, including liver stomach disharmony group of 27 cases,damp-heat syndrome with group of 28 cases, turbid-toxin with erosion group of 35 cases.and according to patients information collected basic data.2 Four groups were divided,named atrophy group, mild intestinal metaplasia group,moderate intestinal metaplasia group, severe intestinal metaplasia group by endoscopy and pathology.3 Detect the expression of Livin?Smac/DIABLO and Caspase-3 in patients' gastric mucosa and serum through IELISA and Immunohistochemistry SP method.4 Observed under the microscope camera fully automatic image analysis of immunohistochemical slices, each slice randomly select 10 vision, by Image-pro plus6.0 image analysis software to analyze the integrated optical density average of positive particles(IOD), then the average of the values obtained 10 IOD for statistical analysis.5 All experimental datas were analyzed by SPSS21.0 statistical analysis software.Results:1 Endoscopy results:turbid-toxin with erosion group under gastroscope is given priority to with dark color,gastric mucosa rough, grainy or nodules, submucosal blood vessels, or chronic hemorrhage;liver stomach disharmony group under gastroscope is given priority to with red oozing, bleeding, bile reflux and mucosa smooth; damp-heat syndrome group under gastroscope is given priority to with mucosal hyperemia and edema obviously erosion,mucus viscosity and turbidity.2 Gastric mucosal pathology: turbid-toxin with erosion group was moderate intestinal metaplasia,severe intestinal metaplasia degree increased significantly, the difference was statistically significant(P<0.05).3 Compared with liver-stomach disharmony and damp-heat syndrome,the level of Livin in serum in Turbid-toxin with erosion group was higher significantly,the difference was statistically significant(P<0.05). Smac/DIABLO and Caspase-3 level were lower significantly,the difference was statistically significant(P<0.05).4 Compared with liver-stomach disharmony and damp-heat syndrome,the expression of Livin in gastric mucosa in Turbid-toxin with erosion group was increased significantly,the difference was statistically significant(P < 0.05). Smac/DIABLO and Caspase-3 expression were decreased significantly,the difference was statistically significant(P<0.05).5 Livin in serum and gastric mucosa of atrophic?mild intestinal metaplasia ? moderate intestinal metaplasia ? severe intestinal metaplasia was increased gradually, the difference was statistically significant(P < 0.05).Smac/DIABLO and Caspase-3 were decreased gradually,the difference was statistically significant(P<0.05).6 Livin in gastric mucosal tissues was negatively correlated with the expression of Smac/DIABLO and Caspase-3(r=-0.697,r=-0.697,P<0.05), the Smac/DIABLO were positively correlated with expression of Caspase-3 and was strongly related(r=1,P<0.05).Conclusions:1 “turbidity toxin” is closely related to atrophy and intestinal metaplasia of gastric mucosa, and is led to an important pathogenic factor in CAG/PLGC.2 “turbidity toxin” increases the chances of atrophy and intestinal metaplasia of gastric mucosa, the mechanism may be Livin in serum and gastric mucosa of patients with increased content and inhibit apoptosis; reduces the content of Smac/DIABLO and Caspase-3, slows down cell apoptosis, cell proliferation, eventually leads to apoptosis and value-added lesions of gastric mucosa caused by imbalance.3 In the process of gastric mucosal atrophy and intestinal metaplasia,the expression of Livin was increased gradually. Livin might promote the occurrence of gastric precancerous lesions, was a damaging factor. Livin detection could be used in clinical diagnosis, and provide reference for clinical outcomes.4 In the process of gastric mucosal atrophy and intestinal metaplasia,the expression of Smac/DIABLO and Caspase-3 were decreased gradually, suggesting that Smac/DIABLO and Caspase-3 reduce the incidence of precancerous lesions of gastric cancer; Smac/DIABLO and Caspase-3 could be used in clinical diagnosis, and provide reference for clinical outcomes.5 There is a clear correlation among Livin and Smac/DIABLO?Caspase-3 in the gastric mucosa.There is a significantly negative correlation between Livin and Smac/DIABLO?Caspase-3.But there is a strong positive correlation between Smac/DIABLO and Caspase-3.The mechanism may be that the expression of Livin in gastric mucosal inhibits the expression of Smac/DIABLO and Caspase-3, and lead to the imbalance between Cell apoptosis and proliferation, and lead to CAG/PLGC in the end.6 The expression of Livin?Smac/DIABLO?and Caspase-3 in serum and gastric mucosa are consistent.Therefore clinical diagnosis by detecting Livin, Smac/DIABLO and Caspase-3 in serum can evaluate the content of gastric mucosal lesion and provide a simple and effective detection method. |
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