Diagnosis and Clinical Significance of Gastric Tunica Mucosa Epithelial Reactive Hyperplasia and Dysplasia

Objective To explore the clinicopathologic features and the clinical significance of the P53 and proliferating cell nuclear antigen(Ki-67) expression for gastric epithelial reactive hyperplasia(GERH) and gastric epithelial low grade dysplasia(GELD).Methods 139 patients with gastric mucosa biopsy combined with epithelial atypical hyperplasia during January 2010 and December 2011 were divided into GERH group(n=106) and GELD group(n=33),based on histomorphology characteristics in pathological change of literature standard.The expression of P53 and Ki-67 in two groups were analyzed.Results In GERH group,most of the patients had obvious inflammation history,and reactive hyperplasia showed differentiation gradually to mucosa surface or to inherent membranae without clear boundary.In GELD group there was obviously clear focal distribution without inflammation,and epithelial dysplasia could extend to mucosa surface or to inherent membranae.The positive expression rate of P53 in GERH group and GELD group were 2.83% and 15.15% respectively,and there was significant difference(P0.05).In GERH group,the positive expression rate(10%) of Ki-67 was 24.53%(26 patients),and most of the positive cells located at basal part of gastric pits(under 1/3) were in 95 patients(89.62%).In GELD group,the positive expression rate(10%) of Ki-67 was 90.90%(30 patients),and the positive cells located at basal and lateral of gastric pits(at 1/3) were in 13 patients(39.39%),The differences were of statistical significance in expressive amount and distributed positions(χ2=46.10,P0.005;χ2=14.83,P0.005).Conclusion The reactive hyperplasia and low grade dysplasia in gastric epithelial can be differentiated by the clinicopathologic features and expression of P53 and Ki-67.