文章：

肠分化与肠型胃癌发生的调控

Control of gut differentiation and intestinal-type gastric carcinogenesis

原文发布日期：2003-08-01

DOI: 10.1038/nrc1141

类型: Review Article

开放获取: 否

要点：

1. Gastric cancer is histologically classified into two main types — intestinal and diffuse.
2. The carcinogenic pathway of intestinal-type gastric carcinomas is believed to begin with Helicobacter pylori infection, followed by chronic gastritis, atrophic gastritis and intestinal metaplasia.
3. Much has been learned recently about the transcriptional control of gut differentiation. Inappropriate activation of the intestine-specific transcription factor CDX2 is one of the most likely contributing factors in the induction of intestinal metaplasia of the stomach.
4. Intestinal metaplasia has been observed not only in the stomach, but also in other digestive organs such as the oesophagus, biliary tracts and gallbladder — possibly as a consequence of inflammatory lesions and regeneration.
5. Several genetic changes have been identified in intestinal-type gastric cancer. These include APC mutations and defects in the MLH1/microsatellite instability pathway, although these defects are only rarely observed. Mutation and/or loss of TP53 have been detected in more than half of the intestinal-type gastric cancers. However, the mechanisms that underlie most cases of this type of cancer remain to be determined.

要点翻译：

1. 胃癌在组织学上主要分为两种类型——肠型和弥漫型。
2. 肠型胃癌的致癌途径被认为始于幽门螺杆菌感染，继而发展为慢性胃炎、萎缩性胃炎和肠上皮化生。
3. 近期关于肠道分化的转录调控机制已有较多研究。肠道特异性转录因子CDX2的异常激活是诱导胃黏膜肠上皮化生最可能的因素之一。
4. 肠上皮化生不仅见于胃部，也出现在其他消化器官如食管、胆道和胆囊——这可能是炎症病变和再生过程的结果。
5. 在肠型胃癌中已发现若干遗传学改变，包括APC基因突变和MLH1/微卫星不稳定性通路缺陷，但这些异常较为罕见。超过半数的肠型胃癌检测到TP53基因突变和/或缺失。然而，该类型胃癌多数病例的发病机制仍有待阐明。

英文摘要：

Gastric cancer is one of the world's most common cancers. Its carcinogenic pathway is mainly associated with Helicobacter pylori infection, subsequent inflammation and tissue regeneration. During the regeneration process, cells deviate from the normal pathway of gastric differentiation to an 'intestinal phenotype', which is thought to be precancerous and associated with the intestinal type of gastric cancer. Inappropriate activation of intestine-specific transcription factors could contribute to the occurrence of the intestinal-type cancer of the stomach.

摘要翻译： 

胃癌是全球最常见的癌症之一。其致癌途径主要与幽门螺杆菌感染、随后的炎症及组织再生有关。在再生过程中，细胞偏离正常的胃分化路径，转而获得“肠表型”，这被认为是癌前状态，并与肠型胃癌相关。肠特异性转录因子的异常激活可能促进肠型胃癌的发生。

原文链接：

Control of gut differentiation and intestinal-type gastric carcinogenesis