The effect of Helicobacter pylori plantation in Barrett's esophagus columnar epithelium on the development of esophagus adenocarcinoma in the elderly
10.3760/cma.j.issn.0254-9026.2014.01.015
- VernacularTitle:幽门螺旋杆菌定植Barrett食管柱状上皮对老年人食管腺癌发生的影响
- Author:
Wei WANG
;
Le XU
- Publication Type:Journal Article
- Keywords:
Barrett's esophagus;
Esophageal neoplasms;
Helicobacter pylori;
Cyclooxygenase 2
- From:
Chinese Journal of Geriatrics
2014;33(1):50-54
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of Helicobacter pylori (Hp) plantation in Barrett's esophagus (BE) columnar epithelium on esophageal adenocarcinoma (EA) in the elderly.Methods 109 patients with reflux esophagitis (RE),51 patients with Barrett's esophagus and 16 patients with esophagus adenocarcinoma were diagnosed by endoscopy and pathological biopsy.The 4-quadrant biopsies in esophagus lesions were respectively taken from each patients.1 were tested by silver staining and urease test for rapid detection of Hp,and the other were stained by HE staining for pathological analysis,AB /PSA staining and immunohistochemistry for gene expressions of cyclooxygenase-2 (COX-2) and B cell lymphoma / leukemia-2 (Bcl-2).Results Hp colonization in RE group,BE group and EA group were 0%,44.4% and 42.1% respectively.The expression levels of COX-2 in abnormal squamous epithelium in RE group,BE group and EA group were 46.7%,100% and 100% respectively.The expression of COX-2 was higher in BE and EA groups than in RE group (x2=126.21,both P<0.05).Moreover,a gradually increase in COX-2 expression was observed in abnormal esophageal squamous epithelium from RE to BE to EA.COX-2 expression was significantly increased in mucosa in BE and EA patients with Hp plantation and in lower esophageal carcinoma in EA patients with Hp plantation and without Hp plantation.Bcl-2 expression in esophageal squamous epithelium was 40.2%,85% and 100% in RE,BE and EA groups respectively.The expression of Bcl-2 was higher in BE and EA groups than in RE group (x2 =125.25,P<0.05).Bcl-2 expression was increased in mucosa BE patients with Hp plantation.Conclusions Hp plantation in BE esophageal columnar epithelium can increase the expression of COX-2,and induce its downstream Bcl-2 expression,inhibit cell apoptosis,and might lead to EA.