| Background and Objective:Varioliform gastritis is a special type of gastritis, also known as chronic erosive gastritis or verrucous gastritis, symptoms and signs are lack of specificity, rely mainly on gastroscope diagnosis. Research shows that, the incidence may be related to Helicobacter pylori (Hp) infection, bile reflux, gastric acid secretion, allergy and other factors.including the most closely relationship with Helicobacter pylori infection.Lack of the basic research of the disease at home and abroad, few in depth reports from molecular level to elucidate the pathogenesis of the disease. All the time since, on the relationship between varioliform gastritis and Helicobacter pylori infection and whether the cancer has attracted close attention of researchers at home and abroad, but the current lack of malignant tendency and micro mechanism of in-depth study of the disease report.A Spanish scholars have reported varioliform gastritis to invasive carcinoma in situ of the case as early as in1960, and Cappell in1988with reports of1cases of varioliform gastritis and gradually evolved into the process of gastric carcinoma. Domestic scholars such as Yao Yirong had5years of uninterrupted clinical follow-up of73cases of varioliform gastritis, found that there are4cases of canceration. the pathology results intramucosal carcinoma, and during follow-up concluded that varioliform gastritis dysplasia (atypical hyperplasia, AH)-polyps-early gastric carcinoma by characteristic gradually carcinogenesis. Upper abdomen symptom of varioliform gastritis is heavier than atrophic gastritis, histological inflammation heavier, and the high incidence of epithelial dysplasia, may be more cancer risks, to cause clinical value. Varioliform gastritis for Sydney1990international conference on gastrointestinal diseases confirmed the special type of chronic gastritis for gastric carcinoma (GC),one of precancerous disease. Helicobacter pylori is an important pathogenic factor of gastric mucosal lesion, recent studies have found that there is a close correlation of Helicobacter pylori infection and gastric carcinoma, by the international agency for research on cancer (IARC) classified as a class I carcinogen.Ki67is a nuclear antigen present in the proliferation of cells, is determined by the molecular weight composition of345KD and395KD of two polypeptide chains of nuclear protein, its functions and chromatin associated, mitosis related with cell proliferation marker, is one of the most widely used at present. Gerdes studies found that the Ki67reaction is closely related to the cell cycle, expression in G1, S, G2, M were in the GO phase, but no expression, but also found that the Ki67in the G1expression of S in early and late trace, gathered at the S stage, especially in the second half period expression rate was significantly increased, while in mitosis the late rapid degradation or loss of antigenic determinant, so that Ki67is one of the most reliable detection of tumor cell proliferation activity index.Current researches showed that in a variety of Ki67expression in malignant tumor is far higher than that of normal tissue,and it is related to the progression,transfer and prognosis of various malignancies.Cycloxygenase (COX) protein, a kind of membrane-bound protein with the function of epoxidation and peroxide synthesis, is the rate-limiting enzyme of prostaglandin biosynthesis. COX is consist of two subtypes:COX-1and COX-2. Previous studies revealed that COX-2is related to atrophic gastritis as well as occurrence, development, transfer, differentiation and prognosis of malignancies, including gastric carcinoma. Ki67, COX-2and the relationship between Hp infection, and their role in the formation process of varioliform gastritis and stomach cancer, has not been reported. This study by detecting Hp in varioliform gastritis and gastric carcinoma lesion tissue, as well as Ki67, COX-2protein expression level, analysis of Ki67, COX-2protein expression and the relationship between Hp infection. Discuss Hp infection caused abnormal gastric epithelial cell proliferation was the occurrence of varioliform gastritis and gastric carcinoma formation of the possible molecular mechanisms, to explore the correlation of varioliform gastritis and Helicobacter pylori and gastric carcinoma.Materials and Methods:To collect gastric pathological specimens drawn from gastric antrum with varioliform gastritis (VG) and chronic atrophic gastritis (NAG) diagnosed definitely by gastroscope and pathological analysis. Varioliform gastritis,117cases as experimental group,45cases of chronic atrophic gastritis,62cases and gastric carcinoma as control group.Varioliform gastritis group,68cases in the immature and mature in49cases (respectively at the center of the verrucous uplift mucosa, flat warts by3cm mucous membrane sampling).Histologic diagnosis by our department.All cases based on the first4weeks did not receive antibiotics, acid inhibitors, bismuth and non-steroidal anti-inflammatory drugs (NSAIDs) such as drug therapy, without any anti-tumor treatment;Unincorporated other malignant tumor;No peptic ulcer (history of stomach and duodenum ulcer) and surgical history. Rapid urease test (RUT) is used to detect Hp. All specimens fixed by10%formaldehyde, conventional paraffin embedding, serial section4μm, and immunohistochemical staining, the expressions of Ki67, COX-2in the tissue were examined respectively under microscope.Result:Varioliform gastritis group (mature, immature) verrucous uplift of the location of the mucous membrane of the HP infection rate is higher, were significantly higher than NAG VG warts by3cm mucous membrane group (mature, immature) and gastric carcinoma group, the difference was statistically significant (p<0.05).Varioliform gastritis group (mature, immature) position of verrucous uplift Ki67of mucosa and gastric carcinoma group, the higher positive rate of COX-2. were significantly higher than NAG, VG warts by3cm mucous membrane group (mature, immature), the difference was statistically significant (p<0.05).Ki67and COX-2expression in varioliform gastritis group (mature, immature) of verrucous uplift position and gastric carcinoma group is higher, was significantly higher than NAG, VG warts by3cm mucous membrane group (mature, immature), the difference was statistically significant (p<0.05).The expression of COX-2and Ki67in VG verrucous uplift position mucous membrane (mature)(80%,57%) and VG verrucous uplift position mucous membrane (immature)(62%,43%) compared with significant difference (p<0.05), but the position of VG verrucous uplift mucosa (mature)(80%,57%) and gastric carcinoma group (84%,62%) compared with no significant difference (p>0.05). NAG, beside the VG warts and mucous membrane of3cm by3cm (mature), VG wart mucosa (immature), VG verrucous uplift position (immature) four groups of mucosal lesions in the Hp positive group Ki67, COX-2expression positive rate were significantly higher than that of Hp negative group, with significant difference (p<0.05). Ki67, COX-2in VG verrucous uplift position mucous membrane (mature), VG verrucous uplift position mucous membrane (immature), gastric carcinoma, express both correlation (p<0.05).Conclusion:The high rate of Hp infection in varioliform gastritis and Ki67, COX-2expression in verrucous uplift lesion enhancement, and helicobacter pylori infection and Ki67, COX-2positive expression has certain relevance, all three may be involved in varioliform gastritis formation of verrucous uplift in the lesion, and involved in the occurrence of gastric carcinoma by abnormal proliferation of the cell.Mature varioliform gastritis (verrucous uplift) potential cancer tend to be higher than that of immature type varioliform gastritis. |
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