摘要
目的：研究萎缩性胃炎患者血清叶酸水平与胃粘膜病变及某些基因变化的关系。方法：胃镜及胃粘膜活检确诊 为中度以上的萎缩性胃炎患者８０例，测定其基础状态及服用叶酸１年后的血清叶酸水平、粘膜病理及ｐ５３、ｐ１６、Ｆａｓ 和增殖细胞核抗原（ＰＣＮＡ）基因表达水平。结果：①血清叶酸水平与萎缩及异型增生负相关显著（Ｐ＝０．００１，Ｐ＝ ０．０５３），与Ｆａｓ表达负相关趋向显著；②随叶酸水平上升，萎缩及肠化呈减轻趋势，高水平时达到显著（Ｐ＝０．００１，Ｐ ＝０．０５２），并伴ｐ５３表达下调（Ｐ＝０．０５６）；③服用叶酸大幅度提高其血清水平者，呈现异型增生明显减轻（Ｐ＝０．０６６）， 并伴Ｆａｓ及ＰＣＮＡ基因表达的明显下调（Ｐ＝０．００７，Ｐ＝０．０８３）。结论：补充叶酸可以影响胃粘膜基因调节，减轻损 伤，抑制增殖，使萎缩、肠化及异型增生明显改善，从而阻断胃癌癌前病变的进展。因此，叶酸可以治疗萎缩性胃炎 并干预胃癌的发生。
Aims: To study the relationships between the serum folate, mucosal lesions and some gene expressions in patients with atrophic gastritis. Methods: In 80 patients with moderate and severe atrophic gastritis diagnosed by endoscopy and histology, the serum folate, mucosal lesions and gene expressions of p53, pl6, Fas and proliferating cell nulear antigen (PCNA) were determined at baseline and one year after folic acid supplementation using microbiological, pathological and immunohistochemical assays. Results: ①The serum folate was negatively correlated with atrophy(P =0.001), dysplasia(P=0.053) and Fas expression(P=0.09); ②along with the elevated folate level, atrophy and intestinal metaplasia showed ameliorating tendency and reached statistical significance at high folate level(P=0.001, P=0.052) with down-regalation of p53(P=0.056); ③one year after the remarked increase in folate level, there was improvement of dysplasia(P= 0.066) and down-regulation of gene expression of Fas and PCNA(P=0.007, P=0.083). Conclusions: Folate supplementation may influence some gene expressions in gastric mucosa, resulting in decrease of damage, inhibition of proliferation and improvement of atrophy, intestinal metaplasia and dysplasia, leading to blockage of precancerous process. Hence, folic acid may be used to treat atrophic gastritis and intervene the gastric carcinogenesis.
出处
《胃肠病学》
2002年第2期86-89,共4页
Chinese Journal of Gastroenterology
