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【Objectives】There is a high incidence of gastric cancer in the northern areas of Shannxi province. Reviewed the endoscopic data of the affiliated hospital of Yan’an University nearly a decade to learn about the change of the epidemiologic features of gastric cancer in this area; and 30 cases of the fresh tissues from the patients with gastric cancer, which were diagnosed through gastric biopsy, had been tested the levels of T cell subtypes , cytokines HGF and IL-10 in their peripheral blood, compared with the normal population, to find immunity differences about them and to explore pathogenesis of gastric cancer.【Methods】1. The endoscopic detection findings, which came from newly diagnosed gastric cancer cases in the endoscope room of the affiliated hospital of Yan’an University in two intervals November 2002- October 2003 and November 2008 - October 2010 for nearly 10 years , were analyzed the epidemiologic changes of gastric cancer in this region.2. From June 2010 as beginning, 30 patients which were diagnosed advanced stage of gastric cancer through gastric biopsy, including 22 males and 8 females, aged from 46 years old to 73, with mean value of 58.91±8.26 years, random collected as study group. Meanwhile, 30 people with good health which were found in the normal physical examination, 21 males and 9 females, aged 31-72 years old, with mean value of 52.97±10.15 years, were collected as control group. All the cases were taken a specimen of fasting blood plasma, which were tested the level of T cell subsets by FCM, and the level of cytokine IL-10 and HGF expression values by the means of ELISA.【Results】1. Endoscopic gastric cancer detection rate from 4.91% (November 2002- October 2003) to 3.14%( November 2008 - October 2010), (χ2 = 52.47, P <0.001), which showed the detection rate has decreased. The difference of the gender did not change significantly between before and after. The male still were in the majority, for which the male/female ratio were 2.91-3.37:1. As viewed of the geography, there has been a high level of gastric cancer detection rate in Yan’an district, as high detection rate areas as the urban area of Yan’an, Ansai County, Yanchang county and Zichang county, and relatively low detection rate of areas as Ganqian County and Luochuan County, etc. The incidence of gastric cancer in farmer were higher than other occupation, accounting for 74% or 71% in the number of gastric cancer. The detection rate of 0.071% of early gastric cancer, accounting for 1.90% of the detected gastric cancer, was below the level reported in China. HP-positive patients with gastric cancer was 16.97% which is lower than the level reported in the literature. The positive rate of HP of the late detection of patients with gastric cancer is higher than it in early (χ2 = 21.64, P <0.001), while the positive rate of HP in the lower gastric cancer and upper gastric cancer were no significant difference (χ2 = 0.341, P = 0.559).2. The peripheral blood levels of T cell subtypes are not statistically significant between study group and control group. The average peripheral levels of CD4+ T cells is 59.64±6.22%, CD8+ T cell levels 35.36±6.55%, with CD4+ / CD8+ ratio average level of 1.78±0.59, and compared with the control group, P values were 0.854, 0.464 and 0.387.3. There are significantly different values of cytokines IL-10 and HGF expression between study group and control group , which the mean values of HGF levels in study group , 643.59±173.47 pg / ml, are higher than in control group, 425.71±138.56 pg/ml and the mean values of cytokines IL-10 of study group , 16.77±4.87 pg / ml, are higher than11.98±3.95 pg / ml of control group. The levels of cytokines IL-10 has a positive correlation to HGF.【Conclusions】1.The detection rate of gastric cancer has declined. However, the high incidence of gastric cancer remains in Northern Shaanxi Province. Rural population are still the main casualties of gastric cancer. Strengthening the research of the regional difference may contribute to searching for the etiology of gastric cancer. As the same time, a variety of effective methods must be adopted to improve the detection rate of early gastric cancer. 2. Blood levels of T cell subtypes ,especially the values of CD4+/CD8+ ,may not form an estimate of the level of the immune responsibilities in terms of newly gastric cancer, even the level of expression of tumor immunity. It would be more reasonable to excluding the interference factors or setting an own self-control to learn the change of the immune responsibilities in a period.3. In the peripheral blood, HGF and IL-10 expression level was positively correlated, and the values of gastric cancer patients were significantly higher than them in the control group. It shows that both HGF and IL-10 play an important role in gastric cancer immune response. HGF as a pleiotropic cytokine promotes the differentiation of DCs, which then expresses of Treg-related transcription factor FoxP3, thereby up-regulating IL-10 productions or enhances HO-1 expression in macrophages to stimulate IL-10 synthesis. HGF, TGF-β1 and IL-10 all together to create an immune evasion microenvironment for tumor cell, promoting tumor cell growth and metastasis, leading to deterioration of gastric carcinoma. Eradication of cancer-related inflammation and breaking the immune tolerance could be an important measure for prevention and treatment of malignant tumors, but also will become an important direction for cancer research.
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