| OBJECTIVE To compare the histological characteristics, including H.pylori infection, neutrophil infiltration, lymphocytic infiltration, mucous glands atrophy, intestinal metaplasia of the adjacent mucosa of early gastric cancer with the control gastric mucosa.Analysis the risk factors of early gastric cancer. According to Lauren's classification, the early gastric cancer was divided into the intestinal type and diffuse type, and compare their differentiation. And for the H. pylori positive early gastric cancer patients, analysis the characteristics of adjacent mucosa with their control group all alone. Immunohistochemical method is applied to compare the expression of human epidermal growth factor receptor 2(HER2) in the mucosa of early cancer, adjacent mucosa, contrast mucosa of stomach, to study the relationship between HER2and early gastric cancer, and evaluate the value of HER2 in the diagnosis and prognosis of early gastric cancer.METHODS Patients with early gastric cancer (EGC), except cardiaccancer, were selected from people who underwent radical surgery at our hospital between January 2011 and July 2014. To perform a case-controlled study, one age-(± 3 years) and sex-matched control subject for each cancer patient was randomly selected from the routine gastroscopy group. Take each one specimen from the gastric body, gastric angle, gastric antrum respectively from the two group, when come to the cancerous tissue, choose the mucosa 2cm far from the cancerous tissue. All specimens were sliced and stained with HE stain, Giemsa stain, AB-PAS stain respectively. Use the Paired Logistic regression model to analysis the risk factors for gastric cancer. For patients with H. pylori-positive and their control group, we observed their differences.In intestinal and diffuse type gastric mucosa,we compairded their difference.too. Envision immunohistochemical assay of epidermal growth factor receptor 2 expression was applied in the mucosa of early gastric cancer, adjacent mucosa, contract mucosa of stomach. SPSS 17.0 statistical analysis was applied for these data.RESULT1.Compare the H.pylori positive rate of case group and the contrast, there was statistical significance between the two group (P< 0.05).Comparison that of intestinal type and diffuse type of early gastric cancer h. pylori positive rate showed that there was no significant statistically difference (P> 0.05).2.The paired logistic regression analysis showed that the OR of H. pylori positive, neutrophil infiltration is increased significantly compared with the control group (P< 0.05).3. Comparison of case group of H. pylori positive with their matched group f H. pylori positive, the OR of lymphocytic infiltration in gastric body increased obviously (P< 0.05).4.1n diffuse gastric cancer, neutrophil infiltration and H. pylori positive in gastric body is higher than that of the control group obviously (P< 0.05); In the intestinal type of gastric cancer, the OR of glands atrophy and intestinal metaplasia in gastric antrum and angulus is higher significantly than that of the control group (P< 0.05).5. The HER2 expression in chronic gastritis,in the mucosa tissue adjacent to carcinoma and the early gastric cancer tissue differences statistically significant (P< 0.05);(2) The HER2 expression rate of diffuse gastric cancer is significantly lower than that of the intestinal type gastric cancer (P< 0.05).Conclusion The inflammation of the gastric mucosa caused by H. pylori is closely related to the occurrence of early gastric cancer. But the background of mocusa of early diffuse gastric cancer and intestinal gastric cancer is different:The mucosa background of intestinal gastric cancer is primary with serious glands atrophy and intestinal metaplasia, inflammatory cells is mainly the lymphocyte cells; Diffuse gastric cancer is given priority to with non atrophic gastritis or mild atrophic gastritis, in addition to large lymphocyte, neutrophils is also clearly visible.HER2 expression have a certain relationship with the intestinal early gastric cancer, and the expression of HER2 degree have a certain value in the diagnosis and prognosis of early gastric cancer... |
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