Department of Internal Medicine, TTUHSC Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905-2709, USA.
Dig Dis Sci. 2011 Nov;56(11):3220-5. doi: 10.1007/s10620-011-1758-z. Epub 2011 Jun 22.
Gastric secretion can provide valuable information especially when Helicobacter pylori (Hp) infection results in chronic atrophic gastritis (CAG) and intestinal metaplasia (IM) preceding adenocarcinoma (AdCa).
Looking for a potential biomarker of malignant transformation in the setting of chronic inflammation we studied the levels of prostaglandin E2 (PGE(2)), as well as peptide growth factors [epidermal growth factor (EGF) and transforming growth factor α (TGFα)], harbingers of injury and repair, in gastric juice aspirated at endoscopy from patients with CAG, CAG/IM, AdCa, and controls.
The PGE(2), EGF and TGFα concentrations in the gastric juice were measured using radioimmunoassays (RIAs).
In patients with AdCa gastric juice PGE(2) increased fivefold versus controls (P < 0.01) and almost threefold versus patients with CAG (P < 0.05). The EGF levels in patients with AdCa were fourfold higher versus controls (P < 0.001) and almost threefold higher versus CAG (P < 0.05). In patients with CAG/IM the EGF levels were also almost 3 times higher versus controls. The TGFα levels in patients with AdCa were half the value of controls and CAG (P < 0.05). In patients with CAG/IM the levels were as low as 1/5 of controls or CAG (P < 0.05).
Testing the gastric juice for PGE(2), EGF, and TGFα in patients with endoscopy and biopsy proven CAG, may be helpful in follow up of patients who may potentially progress to IM and ultimately AdCa. This could be considered as an adjunct to histologic assessment especially that even the best surveillance biopsy specimen regimens are inherited with sampling errors.
胃分泌液能提供有价值的信息，特别是在幽门螺杆菌（Hp）感染导致慢性萎缩性胃炎（CAG）和肠化生（IM），继而发展为腺癌（AdCa）时。
在慢性炎症的背景下，我们寻找恶性转化的潜在生物标志物，研究了内镜抽吸胃液中前列腺素 E2（PGE2）以及肽生长因子[表皮生长因子（EGF）和转化生长因子α（TGFα）]的水平，这些因子是损伤和修复的标志物，存在于 CAG、CAG/IM、AdCa 和对照组患者的胃中。
采用放射免疫分析法（RIA）测定胃液中 PGE2、EGF 和 TGFα的浓度。
与对照组相比，AdCa 患者胃液中 PGE2 增加了 5 倍（P<0.01），与 CAG 患者相比增加了近 3 倍（P<0.05）。AdCa 患者的 EGF 水平比对照组高 4 倍（P<0.001），比 CAG 患者高近 3 倍（P<0.05）。在 CAG/IM 患者中，EGF 水平也比对照组高近 3 倍。AdCa 患者的 TGFα水平是对照组和 CAG 的一半（P<0.05）。在 CAG/IM 患者中，水平低至对照组或 CAG 的 1/5（P<0.05）。
在有内镜和活检证实的 CAG 的患者中检测胃液中的 PGE2、EGF 和 TGFα，可能有助于随访可能进展为 IM 并最终发展为 AdCa 的患者。这可以被认为是组织学评估的辅助手段，特别是即使是最好的监测活检标本方案也存在采样误差。
