血小板反应素蛋白2在高原地区胃黏膜炎性病变及胃癌患者中表达的差异研究

doi:10.3969/j.issn.1007-9572.2016.26.012

摘要/Abstract

摘要： 背景　血小板反应素蛋白2（THBS2）在成纤维细胞中高表达，在内皮细胞中则缺乏表达。研究显示，THBS2在正常组织中高表达，在胃癌及成骨肉瘤中表达明显下降，提示与肿瘤的形成呈负相关。青海位于青藏高原且是胃癌高发区，THBS2在高原地区胃癌患者的表达情况尚未见文献报道。目的　研究THBS2在高原地区患者胃黏膜炎性病变及胃癌组织中的表达情况，探讨THBS2与高原地区不同胃黏膜病变间的关系及意义。方法　选取2012年12月—2015年2月青海大学附属医院腔镜中心检查的30例胃黏膜炎性病变患者的标本及青海省人民医院住院的30例胃癌患者的手术标本〔分别取胃癌组织、癌旁组织（距离胃癌组织5 cm）及正常胃黏膜组织〕，采用组织芯片技术和免疫组织化学方法检测胃黏膜组织THBS2表达情况，采用实时荧光定量反转录聚合酶链式反应（RT-qPCR）法检测THBS2 mRNA表达情况。比较不同临床特征患者胃黏膜炎性病变及胃癌组织中THBS2、THBS2 mRNA阳性率的差异。结果　免疫组织化学法显示，THBS2主要表达于细胞质和细胞膜中，呈现黄色或棕黄色染色。胃黏膜炎性病变组织THBS2、THBS2 mRNA阳性率较正常胃黏膜组织、胃癌组织升高（P0.05）。正常胃黏膜组织、癌旁组织及胃癌组织THBS2、THBS2 mRNA阳性率比较，差异无统计学意义（P>0.05）。不同性别、年龄、民族、肿瘤大小、有无淋巴结转移患者胃癌组织THBS2、THBS2 mRNA阳性率比较，差异无统计学意义（P>0.05）；不同分化程度、浸润深度胃癌组织THBS2、THBS2 mRNA阳性率比较，差异有统计学意义（P<0.05）。结论　THBS2可能参与了高原地区人群胃黏膜炎性病变的发生、发展,THBS2表达与胃癌的分化程度、浸润深度相关，THBS2可以作为胃黏膜炎性病变进展及胃癌预后或观察疗效的指标。

关键词: 胃肿瘤, 胃炎, 胃黏膜, 血小板反应素蛋白2, 高海拔

Abstract: Background　THBS2 is highly expressed in fibroblasts but is insufficiently expressed in endothelial cells.THBS2 is also highly expressed in normal tissues,but its expression in gastric cancer and osteogenic sarcoma is decreased.Thus,THBS2 expression is negatively correlated with tumor formation.A high incidence of gastric cancer is recorded in Qinghai Province on Qinghai-Tibet Plateau.However,the expression conditions of THBS2 in gastric cancer patients on plateaus have yet to be reported.Objective　To investigate the expression conditions of THBS2 in gastric mucosa inflammatory lesions and gastric cancer tissues of patients on plateaus and to explore the relationship and significance between THBS2 and different gastric mucosa lesions of patients on plateaus.Methods　Specimens were collected from 30 cases with gastric mucosal inflammatory lesions inspected by the Endoscopy Center of Qinghai University Affiliated Hospital.Surgical specimens were also obtained from 30 gastric cancer patients admitted to Qinghai Provincial People’s Hospital from December 2012 to February 2015.The specimens were taken from gastric cancer tissues,para-carcinoma tissues located 5 cm away from gastric cancer tissues,and normal gastric mucosal tissues.The expression of THBS2 in gastric mucosal tissues was detected through tissue microarray and immunohistochemical analysis.The mRNA expression of THBS2 was determined through RT-qPCR.Differences in positive rates between THBS2 and its mRNA in gastric mucosal inflammatory lesions and gastric cancer tissues with various clinical features were then compared.Results　Immunohistochemical analysis revealed that THBS2 is mainly expressed in the cytoplasm and the cell membrane,as indicated by yellow and claybank stains.The positive rates of THBS2 and its mRNA in gastric mucosal inflammatory lesions were significantly higher than those in normal gastric mucosa and gastric cancer tissues（P<0.017）.The positive rates of THBS2 and its mRNA in gastric mucosal inflammatory lesions in different genders,ages,nationalities,and lesion types did not significantly differ（P>0.05）.The positive rates of THBS2 and its mRNA in normal gastric mucosa,para-carcinoma tissues,and gastric cancer tissues did not also significantly differ（P>0.05）.Likewise,the positive rates of THBS2 and its mRNA in gastric cancer tissues of patients with different genders,ages,nationalities,tumor sizes,and metastatic or non-metastatic lymph nodes did not significantly vary（P>0.05）.By comparison,the positive rates of THBS2 and its mRNA in gastric cancer tissues with various degrees and depths of invasion significantly differed（P<0.05）.Conclusion　THBS2 may be involved in the occurrence and development of gastric mucosal inflammatory lesions among patients on plateaus.THBS2 expression is highly associated with the differentiation degrees and invasion depths of gastric cancer.Therefore,THBS2 can be considered an indicator of the development of gastric mucosal inflammatory lesions and prognosis of gastric cancer or observation of curative effects.

Key words: Stomach neoplasms, Gastritis, Gastric mucosa, THBS2, Altitude

贺春兰, 张梦兰, 杨勇, 苟笑丹, 贺菊香, 李菊英. 血小板反应素蛋白2在高原地区胃黏膜炎性病变及胃癌患者中表达的差异研究[J]. 中国全科医学, 2016, 19(26): 3185-3190.

HE Chun-lan, ZHANG Meng-lan, YANG Yong, GOU Xiao-dan, HE Ju-xiang, LI Ju-ying. Differences in the Expression of THBS2 in Gastric Mucosal Inflammatory Lesions and Gastric Cancer Tissues of Patients on Plateaus[J]. Chinese General Practice, 2016, 19(26): 3185-3190.

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