장상피화생, 위샘종 그리고 위샘암에서 p27과 p53 family에 대한 면역조직화학적 연구.

Abstract

The expression of p27 and the p53 protein family in intestinal metaplasia with or without helicobacter pylori infection, tubular adenoma(low, high grade) and gadenocarcinoma of the stomach.

Choi, Chong-Hwan Advisor:Prof. Suh, Chae-Hong, Ph.D. Department of Medicine, Graduate School, Chosun University

p27 is a member of a family of CDK inhibitors that bind to cyclin/CDK complexes and arrest cell division. There is considerable evidence that p27 plays an important role in multiple fundamental cellular processes, including cell proliferaion, cell differentiation, and apoptosis. Although the p53 tumor suppressor has been extensively studied, many critical questions remain unanswered about the biological functions of p53 homologs, p73 and p63. Accumulating evidence suggests that both p73 and p63 play important roles in regulation of apoptosis and cell differentiation. However, there are very few reports on the immunohisto- chemical expression of p27, p53 protein family in intestinal metaplasia, gastric adenoma and its significance in the progression of gastric adenomas to gastric adenocarcinomas is unclear, We therefore performed an immnohistochemical study for p27, p53, p63, p73 expression in intestinal metaplasia, gastric adenoma with low- and high grade dysplasia, early gastric cancer and advanced gastric adenocarcinoma The characteristics of positive staining for p27, p53 homologs, p73 and p63 was evaluated in 47 intestinal metaplasia with or without H. pylori 33 tubular adenoma, gastic adenocarcinoma classified into early stage (19), and advanced stage (38), and that classified into intestinal (47), and diffuse type (10). The aim of this study was to evaluate the value of overexpression of p27, p53, p73 and p63 as gastric cacinogenesis and prognostic factors in intestinal metaplasia, tubular adenoma and gastric adenocarconoma. p27 immunoreactivity was significantly increased in intestinal metaplasia with H. pylori, tubular adenoma(low grade, high grade) and adenocarcinoma, intestinal type. Expression of p53 was increased in intestinal metaplasia with H. pylori, tubulas adenoma(low grade, high grade), and adenocarcinoma, in testinal type p53 expression was significantly increased in high grade, tubular adenoma, Adenocarcinoma, intestinal type. Expression p63 was increased in intestinal metaplasia with H. pylori, tubular adenoma(low grade, high grade), and expression was similar in early gastric carcinoma and advanced gastric carcinoma. p73 expression was significally increased in tubular adenoma, low and high grade. In conclusion p53 protein family, p73 and p63 may be useful as an indicator of development and progression in tubular adenoma (low grade high grade) early stage gastric cancers but this is not the case for advanced stage gastric adenocarcinoma. There results suggest that the p27 and p53 family may play a role in the epithelial cell response to H. pylori.