Saf Coskun, Gulcan Enver Mahir, Ozkan Ferda, Cobanoglu Saf Seyhan Perihan, Vitrinel Ayca
aKastamonu Dr. Munif İslamoglu State Hospital, Department of Pediatrics, Kastamonu bDepartment of Pediatric Gastroenterology and Hepatology, Acibadem University cDepartment of Pathology, Yeditepe University, Istanbul, Turkey dDepartment of Pediatrics, Yeditepe University, Istanbul, Turkey.
Eur J Gastroenterol Hepatol. 2015 Feb;27(2):155-61. doi: 10.1097/MEG.0000000000000246.
Helicobacter pylori that is generally acquired in childhood and infects the gastric mucosa is considered to be responsible for many pathobiological changes that are linked to the pathogenesis of gastric cancer. Although the majority of studies on the subject have been carried out in adults, there are a limited number of studies on children that reflect the early period of infection and may be of greater significance.
We aimed to determine the role of H. pylori infection and/or gastritis in several histopathological changes, p53, p21, and cell proliferation-associated Ki-67 antigen expression in the gastric mucosa.
We studied 60 patients with a mean age of 7.5 ± 4.5 years at referral. On the basis of endoscopic appearance and the evaluation of the gastric antral specimens, the patients were divided into three groups: patients without gastritis, patients with H. pylori-positive gastritis, and patients with H. pylori-negative gastritis. To determine the expression of p53, Ki-67, and p21 in gastric biopsy specimens, immunohistochemical stains were performed.
The incidence of neutrophil activity, which was one of our histopathologic parameters, was significantly higher in the H. pylori-positive gastritis group than the other two groups. The presence of lymphoid aggregate was more frequent in H. pylori ± gastritis groups than the nongastritis group. p53 expression was found to be significantly higher in the H. pylori-positive gastritis group than the nongastritis group. Ki-67 and p21 expressions were significantly more frequent in the H. pylori-positive gastritis group than the other two groups. When we evaluated the density of H. pylori, as the density of bacteria increases, we found that the expressions of p53, p21, and Ki-67 increased significantly.
Expression of the studied precancerous markers in significant amounts indicates the importance of childhood H. pylori infection in the constitution of gastric cancer in adulthood.
幽门螺杆菌通常在儿童期感染胃黏膜，被认为与许多与胃癌发病机制相关的病理生物学变化有关。尽管关于该主题的大多数研究是在成人中进行的，但针对儿童感染早期的研究数量有限，可能具有更大的意义。
我们旨在确定幽门螺杆菌感染和/或胃炎在胃黏膜的几种组织病理学变化、p53、p21以及细胞增殖相关的Ki-67抗原表达中的作用。
我们研究了60例转诊时平均年龄为7.5±4.5岁的患者。根据内镜表现和胃窦标本评估，将患者分为三组：无胃炎患者、幽门螺杆菌阳性胃炎患者和幽门螺杆菌阴性胃炎患者。为了确定胃活检标本中p53、Ki-67和p21的表达，进行了免疫组织化学染色。
作为我们组织病理学参数之一的中性粒细胞活性发生率，在幽门螺杆菌阳性胃炎组显著高于其他两组。幽门螺杆菌±胃炎组中淋巴滤泡的存在比非胃炎组更频繁。发现幽门螺杆菌阳性胃炎组的p53表达显著高于非胃炎组。幽门螺杆菌阳性胃炎组的Ki-67和p21表达显著高于其他两组。当我们评估幽门螺杆菌的密度时，发现随着细菌密度增加，p53、p21和Ki-67的表达显著增加。
大量研究的癌前标志物表达表明儿童期幽门螺杆菌感染在成年胃癌构成中的重要性。
