Kang Hyung Min, Kim Nayoung, Park Young Soo, Hwang Jin-Hyeok, Kim Jin-Wook, Jeong Sook-Hyang, Lee Dong Ho, Lee Hye Seung, Jung Hyun Chae, Song In Sung
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
J Clin Gastroenterol. 2008 Jan;42(1):29-35. doi: 10.1097/MCG.0b013e3180653cb7.
This study was performed to determine the gastric distributions of MUC5AC and MUC6 depending on Helicobacter pylori (H. pylori) infection, and to evaluate whether the expressions of MUC5 and MUC6 change in H. pylori-associated gastroduodenal diseases. In addition, MUC5AC and MUC6 expressional changes were investigated before and after H. pylori eradication.
In the 224 individuals (136 H. pylori-positive and 88 H. pylori-negative) who came from control (N=48), duodenal ulcer (N=35), benign gastric ulcer (N=61), dysplasia plus stomach cancer (N=80) groups, MUC5AC and MUC6 expressions were determined by immunohistochemical staining in the antrum and body, respectively. This staining for MUC5AC and MUC6 were reperformed in 113 of the 136 H. pylori-positive patients after successful H. pylori eradication by proton pump inhibitor-based triple therapy.
(1) No difference was found between the H. pylori-positive and negative groups in terms of MUC5AC expression. In contrast, MUC6 expression was significantly lower in the H. pylori-positive group than in the H. pylori-negative group in the gastric body. Moreover, reduced MUC6 expression increased to the H. pylori-negative level after eradication. (2) Expressions of MUC5AC and MUC6 were significantly lower in the dysplasia plus cancer group than those of control in case of H. pylori positive. Similarly, MUC5AC and MUC6 expressions were significantly lower in the presence of atrophic gastritis with intestinal metaplasia in case of H. pylori positive. (3) Aberrant expressions of MUC6 in foveolar cells were observed in both antrum (11.3%) and body (5.3%) only in the H. pylori-positive group, but this reverted to normal after H. pylori eradication.
These results suggest that H. pylori infection causes alterations of mucin expression, closely related with the development of gastric atrophy with intestinal metaplasia, probably contributing to carcinogenesis.
本研究旨在确定根据幽门螺杆菌（H. pylori）感染情况，MUC5AC和MUC6在胃内的分布，并评估在幽门螺杆菌相关的胃十二指肠疾病中MUC5和MUC6的表达是否发生变化。此外，还研究了幽门螺杆菌根除前后MUC5AC和MUC6表达的变化。
在来自对照组（N = 48）、十二指肠溃疡组（N = 35）、良性胃溃疡组（N = 61）、发育异常加胃癌组（N = 80）的224名个体（136名幽门螺杆菌阳性和88名幽门螺杆菌阴性）中，分别通过免疫组织化学染色测定胃窦和胃体中MUC5AC和MUC6的表达。在136名幽门螺杆菌阳性患者中，113名患者在基于质子泵抑制剂的三联疗法成功根除幽门螺杆菌后，重新进行了MUC5AC和MUC6的染色。
（1）幽门螺杆菌阳性和阴性组在MUC5AC表达方面无差异。相比之下，幽门螺杆菌阳性组胃体中MUC6的表达明显低于幽门螺杆菌阴性组。此外，根除后MUC6表达降低的情况恢复到幽门螺杆菌阴性水平。（2）在幽门螺杆菌阳性的情况下，发育异常加癌症组中MUC5AC和MUC6的表达明显低于对照组。同样，在幽门螺杆菌阳性且存在萎缩性胃炎伴肠化生的情况下，MUC5AC和MUC6的表达也明显降低。（3）仅在幽门螺杆菌阳性组的胃窦（11.3%）和胃体（5.3%）中观察到小凹细胞中MUC6的异常表达，但在幽门螺杆菌根除后恢复正常。
这些结果表明，幽门螺杆菌感染导致粘蛋白表达改变，这与胃萎缩伴肠化生的发展密切相关，可能促成癌变。
