Cases Of Chronic Gastritis Research Articles

Helicobacter pylori cagA, vacA, iceA and babA Genotypes from Peruvian Patients with Gastric Intestinal Metaplasia.

We explored the clinical-stage association of gastric intestinal metaplasia (IM) compared to cases of chronic non-atrophic gastritis (CNAG) and its relationship with virulence genotypes of Helicobacter pylori (H. pylori) clinical isolates from patients with dyspepsia in Peru. This study was cross-sectional and included 158 H. pylori clinical isolates; each isolate corresponded to a different Peruvian patient, genotyped by polymerase chain reaction to detect cagA gene and EPIYA motifs, the vacA gene (alleles s1, s2, i1, i2, d1, d2, m1, m2 and subtypes s1a, s1b and s1c), the iceA gene (alleles 1 and 2), and the babA gene (allele 2). We observed that 38.6% presented with IM and that all clinical isolates were CagA positive. The EPIYA-ABC motif was predominant (68.4%), and we observed a high frequency for the vacA gene alleles s1 (94.9%), m1 (81.7%), i1 (63.9%), and d1 (70.9%). Strains with both iceA alleles were also detected (69.6%) and 52.2% were babA2 positive. In addition, it was observed that the cagA+/vacAs1m1 (PR: 2.42, 1.14 to 5.13, p < 0.05) and cagA+/vacAs1am1 (PR: 1.67, 1.13 to 2.45, p < 0.01) genotypes were associated with IM. Our findings revealed the cagA and vacA risk genotypes predominance, and we provided clinically relevant associations between Peruvian patients with H. pylori infection and IM clinical stage.

Pro-Inflammatory Diet as a Risk Factor for Stomach Cancer: Findings from a Multicenter Study in Central and Western China.

We conducted a multicenter cross-sectional study in central and western China to explore the association between inflammatory diet and stomach cancer odds. Participants from five hospitals in the central and western regions were collected. All participants completed the questionnaire we provided before the gastroscopy examination, which includes inquiries about risk factors for stomach cancer and food frequency. All participants underwent gastroscopy, and a mucosal biopsy was confirmed pathologically. Pathological findings were classified as chronic gastritis group, precancerous lesions group and stomach cancer group. Dietary Inflammatory Index (DII) scores were calculated based on the frequency of food occurrences in the questionnaire, and finally SPSS was used to calculate the correlation between variables. A total of 1162 patients were included in this study, including 668 cases of chronic gastritis, 411 cases of precancerous lesions, and 83 cases of cancer. A single factor analysis was conducted to examine the risk factors of stomach cancer, revealing a significant association between a pro-inflammatory diet and the stomach cancer odds (p value < 0.05). The results of binary classification analysis further confirmed that a pro-inflammatory diet is a risk factor for stomach cancer 【odds ratio (OR) =7.400)】. Moreover, correlation analysis demonstrated a positive correlation between the severity of gastric mucosal diseases and an inflammatory diet (including anti-inflammatory and pro-inflammatory diets) (rs=0.274, p-value < 0.001). Pro-Inflammatory diet is a risk factor for stomach cancer, and may accelerate the progression of stomach mucosal disease.

Clinical and morphological characteristics of patients with chronic gastritis and high risk of gastric cancer

The purpose of this study is to conduct a clinical and morphological analysis of cases of chronic gastritis with a high risk of gastric cancer (GC). Materials and methods. The study included 26 cases of chronic atrophic gastritis of stages 3 and 4 with a high risk of developing GC according to the assessment using the OLGA system (Operative Link for Gastritis Assessment). The cases were diagnosed on material of gastric tissue biopsy in 2022. In total, 678 histological studies were performed during the year. Cases of chronic gastritis with a high risk of developing GC accounted for 3.8% of all chronic gastritis. Results. Cases of chronic gastritis with a high risk of developing GC were more often observed in older men (average age 67±12 years, ratio 2.25:1). Multifocal atrophic gastritis was in the first place in frequency of occurrence (61.5%), the connection with helicobacter infection was confirmed only in a third of cases (34.6%). Morphological changes were characterized by a predominant lesion of the antrum of the stomach and mixed complete and incomplete intestinal metaplasia. With the exception of one case in which pseudopancreatic metaplasia was detected in the antrum of the stomach, all cases of autoimmune gastritis (n=26) were assigned to stage 2 with a low risk of developing GC, which seems controversial to us. Conclusion. The results of our study showed a high percentage of pre-existing tumor lesions of the stomach in the group of chronic gastritis with a high risk of developing GC. Dysplasia was diagnosed in 5 out of 26 cases, GC with previously performed mucosectomy in 3 out of 26 cases. In addition, the patients had other tumor and precancerous lesions of the gastrointestinal tract. These data show the validity and practical value of using the OLGA system to identify high-risk groups for the development of tumors not only of the stomach, but also of gastrointestinal tumors of other localizations.

Autoimmune gastritis: clinical picture, diagnosis, treatment

The review includes the analysis of modern data about prevalence, clinical picture, endoscopic, morphological, immunological diagnosis and treatment of autoimmune gastritis (AIG). The incidence of AIG is 2–12% of all cases of chronic gastritis. The leading factor in pathogenesis is the formation of autoantibodies to parietal cells and intrinsic Castle factor. AIG is a significant risk factor for vitamin C, B12, and D deficiency. The clinical picture of AIG is nonspecific and may include gastroenterologic, hematologic, and neuropsychiatric syndromes. Morphological diagnosis is the most reliable method for assessing atrophic gastritis, allowing the assessment of the three dynamic stages of AIG. Immunological diagnostics include antibodies to parietal cells and are highly specific. There is no etiotropic and pathogenetic therapy for AIG. Cyanocobalamin replacement therapy is approved in clinical practice.

Detection of Human Boca Virus in Gastric Adenocarcinoma.

Background: Gastric cancer is one of the most common cancers worldwide. Human bocavirus (HBoV), a recently isolated virus, has been investigated for its role in many respiratory and enteric diseases. Few studies have reported its presence in solid tumors, such as lung and colon cancers. The aim of this study was to detect the presence of the HBoV1 genome in gastric adenocarcinoma, which has not yet been evaluated. Methods: Formalin-fixed paraffin-embedded (FFPE) blocks of 189 gastric tumors and 50 blocks of non-tumor gastric tissue products from elective weight reduction operations were collected. DNA extraction and real-time polymerase chain reaction (PCR) were performed for HBoV1 detection. DNA sequencing was performed using ABI Genetic Analyzer series 3500. Results: The mean age of the patients was 60±13.33 years. Tumors were more common in males than females (2.5/1). HBoV1 PCR was positive in 34 (18%) cases of GC and 10 (20%) cases of chronic gastritis (P>0.05). There was no association between age, sex, stage, and histologic subtype of the tumor and HBoV1 positivity (P>0.05) in tumor samples. The rate of intestinal metaplasia and presence of lymphoid stroma were also not more frequent in HBoV1-positive tumors (P>0.05). Conclusion: The HBoV1 can be detected in a relatively high proportion of Iranian patients with gastric cancer (18%) with no predilection for specific subtypes and no association with the degree of lymphocytic infiltration. HBoV1 can also be observed in approximately 20% of chronic gastritis cases. Further comprehensive studies are needed to elucidate the role of HBoV1 in gastric cancer development.

Improving the detection of Helicobacter pylori in biopsies of chronic gastritis: a comparative analysis of H&E, methylene blue, Warthin-Starry, immunohistochemistry, and quantum dots immunohistochemistry.

The objective of the study was to compare the consistency of various staining methods, including H&E, Methylene Blue, Warthin-Starry (W-S), Immunohistochemistry (IHC) and Quantum dots immunohistochemistry (QDs-IHC), in detecting Helicobacter pylori (HP) in cases of mild, moderate and severe chronic gastritis. Biopsy samples were obtained from 225 patients with chronic gastritis at the Department of Pathology, Yichang Central People's Hospital between January 2019 and October 2019. The presence of HP was detected using H&E, Methylene Blue, W-S, IHC, and QDs-IHC. The positive rates for HP detection using H&E, Methylene Blue, W-S, IHC, and QDs-IHC were 42.22%, 51.11%, 53.78%, 59.11%, and 58.67%, respectively. In cases of mild chronic gastritis, the consistency of test results between H&E, Methylene Blue, W-S, and QDs-IHC with IHC were Kappa=0.196, P=0.033, Kappa=0.706, P<0.001, Kappa=0.717, P<0.001, and Kappa=0.968, P<0.001, respectively. Similarly, in cases of moderate chronic gastritis, Kappa values between H&E, Methylene Blue, W-S, and QDs-IHC with IHC were 0.356, P<0.001, 0.655, P<0.001, 0.741, P<0.001, and 0.946, P<0.001, respectively. For cases of severe chronic gastritis, the Kappa values between the staining methods and IHC were 0.271, P=0.037, 0.421, P=0.002, 0.621, P<0.001, and 1, P< 0.001, respectively. The study showed that the positivity rate of IHC was significantly higher than that of H&E, Methylene Blue, and W-S in detecting HP infection in chronic gastritis cases. In terms of consistency with IHC, QDs-IHC was the most reliable staining method across all severity grades, while the agreement between H&E and IHC was poor, and that between Methylene Blue and W-S with IHC was average. Pathology departments may choose the most appropriate staining method based on their specific needs, considering the staining time, contrast, and cost of each method.

CDX2 protein distribution in the gastric mucosa in chronic gastritis by a semi-quantitative index and its reproducibility

Introduction The Cdx2 gene provides an intestinal differentiation of epithelial cells and plays an oncosupressive role. An indirect method of the Cdx2 gene expression assessment is the immunohistochemical study of its product, the CDX2 protein. Therefore, the common approach to the immunohistochemical study of the CDX2 protein hasn’t been developed yet. A semi-quantitative CDX2 index based on the percentage of CDX2-positive cells in the tissue specimen, the staining intensity and an expression pattern has been proposed.The purpose of the study was to assess the reproducibility of the semi-quantitative CDX2 index calculation in chronic atrophic gastritis stages I-IV.Materials and methods 20 chronic atrophic gastritis cases (5 cases for each stage of the gastritis according to the Operative link for gastritis assessment system) were taken according to the Maastricht V protocol and examined by the immunohistochemical method (CDX2, clone EPR2764Y, ready to use). The reproducibility of the CDX2 semi-quantitative index was assessed by five pathologists. An agreement between observed raters was measured by the kappa statistics.Results The Cohen’s κ value is 0,8 for unweighted κ and 0,97 for weighted κ (extremely high level of agreement) for the semi-quantitative CDX2 index calculation.Discussion The least reproducible parameter used for the semi-quantitative CDX2 index calculation the percentage of CDX2-positive cells because of the subjective assessment. The Cohen’s weighted κ value was higher compared to the unweighted κ because of the close yet not similar CDX2 semi-quantitative index values calculated by pathologists.Conclusion The semi-quantitative CDX2 index can be used to rank CDX2 expression and has a high level of reproducibility.

Comparative morphological characteristics of helicobacter pylori and autoimmune gastritis

Objective: to conduct a comparative morphological analysis of helicobacter pylori (H. pylori) and autoimmune gastritis and to determine the significant morphological criteria for differential diagnosis.Materials and methods. 30 cases of chronic atrophic helicobacter gastritis and 30 cases of chronic atrophic autoimmune gastritis were retrospectively selected for the study. In all cases of helicobacter gastritis, the presence of H. pylori was confirmed by morphological diagnostic methods using Giemsa staining or additionally using immunohistochemistry. All cases of autoimmune gastritis were additionally confirmed by clinical and laboratory diagnostic methods, some patients had a long history of follow-up and biopsy material was taken from them repeatedly. A prerequisite was taking at least 5 biopsies according to the Sydney Protocol.Results. The main differential diagnostic feature in our study was the detection of H. pylori, as well as the localization of the lesion in the stomach body characteristic of autoimmune gastritis and in the antrum in helicobacter gastritis. The study groups differed by gender (the predominance of females in the group of autoimmune gastritis), the prevalence and activity of inflammation (all cases of helicobacter gastritis had signs of inflammation activity). When studying the content of neuroendocrine cells in cases of helicobacter gastritis in the stomach body, simple hyperplasia of neuroendocrine cells was noted, in cases of autoimmune gastritis, the appearance of chains and nodules was noted, which corresponded to linear and nodular hyperplasia of neuroendocrine cells.Conclusion. The morphological criteria obtained in the study make it possible to make a differential diagnosis between helicobacter and autoimmune gastritis. This is extremely important because of the differences in treatment approaches and dynamic monitoring tactics in these variants of chronic gastritis.

Epidemiological and Histopathological Aspects of Chronic Gastritis at the Departmental University Teaching Hospital of Borgou Alibori (CHUD-BA) from 2011 to 2021

Background: Gastritis is better evaluated nowadays since the advent of upper gastrointestinal endoscopy. Despite the availability of this workup in Benin Republic, there is a scarcity of data on chronic gastritis. Objective: This work aimed to study the epidemiological and histopathological aspects of chronic gastritis in the Departmental University Teaching Hospital of Borgou Alibori (CHUD-B/A) from 2011 to 2021. Method: This was a retrospective cross-sectional study with descriptive and analytical purposes, carried out from February 23, 2022 to May 23, 2022, among patients who had undergone gastric biopsy and/or gastrectomy from January 2011 to January 2022 (10 year), and whose specimens were sent into the histopathology section of the CHUD-B/A. Non-probability sampling was performed with exhaustive recruitment. A survey form has been used to collect data from patients’ medical records. Pearson’s chi-square and Fisher’s exact tests have been used as appropriate to determine correlations between variables. Result: A total of 310 cases of chronic gastritis were diagnosed in the histopathology section of the CHUD-B/A from 2011 to 2021. This represented a chronic gastritis frequency of 91.45% for all gastric lesions diagnosed throughout the study period. Erythematous gastropathy was the most frequent (70.35%). Helicobacter pylori was present in 36.77% and dysplasia was observed in 12.26% of cases. Erythematous gastropathy was a predictive factor for the absence of gastric dysplasia in histopathology check up (p-value = 0.042). In contrast, intestinal metaplasia was predictive of the presence of gastric dysplasia in histopathology check up (p-value < 0.001). Conclusion: Chronic gastritis is very common in our setting. Systematic biopsy performance in front of an evocative clinical situation followed by histopathological examination may be encouraged.

Assessment of the content of neuroendocrine cells in the gastric mucosa in patients with autoimmune gastritis

The aim of the study was to evaluate the content of neuroendocrine cells in immunohistochemically stained preparations and determine differences in the number of neuroendocrine cells (NEC) in the body of the stomach in autoimmune gastritis (AIG) and other forms of gastritis. Material and methods. The study included 27 cases of AIG and 9 cases of chronic atrophic gastritis not associated with autoimmune mechanisms of disease. The age of the patients ranged from 36 to 77 years and averaged 54.9 years. Biopsies were taken according to accepted protocols: 2–3 biopsies from the antrum and 2 biopsies from the body of the stomach. An immunohistochemical reaction was carried out with an antibody to chromogranin A on an automatic Bond Max immunostainer (Leica, Germany). The slides were digitized on an Aperio AT2 scanner (Leica, Germany), and QuPath v.0.3.0 software for viewing and analyzing digital images of slides was used for morphometric analysis of digital images and counting. The results were processed in the Jamovi program, Version 1.6 ( https://www.jamovi.org ). Results. According to the results of counting in the group of patients with AIG, there was an increase in the quantity of NEC. Ranges of hyperplasia of neuroendocrine cells were revealed: 648–1736 cells per 1 mm2 square were detected for AIG, 416–605 cells per 1 mm2 for other forms of gastritis. In the AIG group median is 925 cells per 1 mm2, the 1st quartil is 877 cells per 1 mm2, 3rd quartil is 1172 cells per 1 mm2, interquartile range is 295 cells per 1 mm2 (asymmetrical distribution). In the group with other forms of gastritis arithmetic mean is 522±23 cells per millimeter square (normal distribution). Conclusion. The obtained results allowed to confirm NEC hyperplasia in patients with AIG. A statistically significant difference was found in the number of NEC in the body of the stomach in the group of AIG and other gastritis (p≤0,01), which can be proposed as an additional morphological criteria for diagnosing AIG.

Histopathological findings in laparoscopic sleeve gastrectomy specimens: Are pathological examinations necessary?

Objective: The objective of this study is to determine the prevalence of gastric histopathological findings in patients who underwent laparoscopic sleeve gastrectomy (LSG) in our hospital and to add more data to the published literature on the characteristics of the resected LSG samples. Material and Methods: The pathology reports of the patients were retrospectively analyzed to identify all patients with consecutive morbidly obesity who underwent LSG from January 2015 to December 2019. All patients underwent gastroscopy in the preoperative period. Results: The study analyzed 800 patient reports. No specific pathological finding was observed in 230/800 (28.75%) of the patients, which was reported as normal. Specific pathological findings were present in 570 (71.25%) patients. Cases of chronic inactive gastritis (400 patients [50%] ), chronic active gastritis (134 patients [16.7%] ), intestinal metaplasia (2 patients [0.2%] ), low-grade dysplasia (1 patient [0.12%] ), stromal tumor (7 patients [0.87%] ), Neuroendocrine (NE) cell hyperplasia (7 patients [0.87%] ), fundic gland polyps (3 patients [0.37%] ), granulomatous gastritis (1 patient [0.12%] ), acute gastritis (1 patient [0.12%] ) and ectopic pancreas (1 patient [0.12%] ) were recorded. Conclusion: Surgeons should be aware of the high unexpected histopathological prevalence in bariatric patients. Although our study did not find any malignant pathological result, we believe that routine postoperative pathological examination and preoperative endoscopy are necessary for medicolegal reasons.

Clinical Observation on 50 Cases of Chronic Atrophic Gastritis Treated by Traditional Chinese Medicine

Clinical Observation on 50 Cases of Chronic Atrophic Gastritis Treated by Traditional Chinese Medicine

Evaluation of OLGA and OLGIM Systems in Madagascar, a Country with Low Economic Resources

Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary potential of the disease, unlike the classifications: “Operative Link On Gastritis Assessment” (OLGA) and “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM). Our goals are to apply and evaluate the three classifications: the Sydney System, OLGA and OLGIM and to draw possible correlations. This is a retrospective, descriptive, single-center study performed on all cases of chronic gastritis, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2013 to December 31, 2017. A review and application of the three main classification systems was performed on each case. We included 298 cases. The mean age was 50.85 years. The sex ratio was 1.48. The high-risk stages according to the “Operative Link On Gastritis Assessment” (OLGA) system and the “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM) system were 0.67% and 2.68%, respectively. We observed a correlation between the two systems with discordance of 5%. The use of the two new systems allows the assessment of the progressive potential of gastritis in patients at risk of developing gastric cancer. For optimal effectiveness of both classifications, biopsies should be performed according to the Sydney System recommendations.

Benign effects of Helicobacter pylori in gastric mucosa among symptomatic Sudanese patients

Introduction:Infection with Helicobacter pylori is a worldwide problem. It plays an important role in gastric malignancies.The pathogenesis of gastric malignancies involves multistep progression changes in gastric mucosaand the Helicobacter pylori infections is the first step in most of cases.Aim:The aims of this study were to clarify the benign changes in gastric mucosa after Helicobacter pylori infection;to evaluate the endoscopic and histological patterns of infection and to correlate endoscopic findingwith histopathological parameters.Materials and Methods:A descriptive, retrospective study was done in Soba University Hospital between January 2009 - February2013. Paraffin-embedded blocks, Giemsa and Haematoxylin and Eosin-stained slides, were obtained from50 cases of Helicobacter pylori-associated chronic gastritis and examined under light microscopy. Theclinical information and endoscopy findings were obtained from the records. The data was analyzed usingStatistical Package for Social Sciences Software.Results:The most common affected age group was between 40-60 years. The prevalence of infection was equal inmales and females. The commonest endoscopic finding was inflammation of gastric mucosa. Most patientspresented with moderate degree of colonization; 62% of patients presented with a severe degree of chronicinflammation. There was a significant statistical correlation between the degree of Helicobacter pylori colonizationand the degree of chronic inflammation (p&lt;0.05). Most patients presented with severe degree ofactive gastritis. A significant correlation was found between the degree of chronic inflammation and degreeof activity. The prevalence of lymphoid follicles in a single biopsy specimen from antral mucosa was 36%.The dysplasia was seen in 12%; eosinophilia 8%; atrophy 8% and intestinal metaplasia in 6% of the cases.No significant correlation was found between the endoscopic findings and histological findings.Conclusion:Helicobacter pylori infection causes chronic active gastritis and it has a role in the development of lymphoidfollicles, intestinal metaplasia, atrophy and dysplasia.

Occurrence of Helicobacter Pylori in Specimens of Chronic Gastritis and Gastric Adenocarcinoma Patients: A Retrospective Study at University Teaching Hospital, Kigali, Rwanda.

Introduction:Helicobacter pylori (H. pylori) infection is the major cause of gastroduodenal diseases in populations of different ages. We conducted aretrospective studyusing archived tissue samples to determine the prevalence of H. pylori infection among patients diagnosed with gastritis and gastric adenocarcinoma by histopathology cases in one hospital in Rwanda.Materials and methods:Cases of chronic gastritis and gastric adenocarcinoma histologically diagnosed in a tertiary hospital in Rwanda over the period of 2016-2018 were studied for the presence of H. pylori using immunohistochemistry. Diagnosis of positive cases considered immunoreactivity as well as bacterial morphology, including spiral, rod-shaped, angulated and coccoid forms.Results:Three hundred and seven cases were included in this study; chronic gastritis and gastric adenocarcinoma representing 39% and 61%, respectively. The overall frequency of H. pylori infection was 77.5% (80% among chronic gastritis cases versus 76% among gastric adenocarcinoma cases). Prevalence of H. pylori infection in chronic gastritis and adenocarcinoma did not significantly associate with age and sex.Conclusion:The prevalence of H. pylori was high among chronic gastritis and gastric adenocarcinoma cases in Rwanda. Pathologists should investigate the presence of H. pylori in gastric biopsies. Our data shows immunohistochemistry method is feasible and adequate to facilitate detection of H. pylori, which may guide timely treatment.

Histopathological Features of the Gastric Mucosa in Patients with Chronic Gastritis and Helicobacter pylori Infection at Pertamina Central Hospital Jakarta

Background: Chronic gastritis is a chronic inflammation of the gastric mucosa, accompanied by changes in mucosal histology with or without Helicobacter pylori infection. Changes in the gastric mucosa include gastric mucosal atrophy, intestinal metaplasia, and epithelial dysplasia. Purposes: This study aims to determine the microscopic appearance of the mucosa in chronic gastritis patients based on standard histopathological criteria, which include gland atrophy, intestinal metaplasia, dysplasia with or without Helicobacter pylori infection at Pertamina Central Hospital Jakarta period 2018 - 2019. Methods: This retrospective study was conducted in a cross-sectional study from March 15 to March 25, 2020. Results: This study reported 303 cases of active chronic gastritis (38.4%) out of 790 total samples that met the inclusion criteria. Microscopic changes of the mucosa were found in the form of atrophy of the mucous glands in 254 cases (32.2%), intestinal metaplasia in 25 cases (3.2%), and epithelial dysplasia cases in 23 cases (2.9%). Conclusion: the proportion of active chronic gastritis patients found in this study was helicobacter pylori infection is more dominantly found in patients with active chronic gastritis than in non-active chronic gastritis. The description of atrophic glands in chronic gastritis patients was more dominant than parameters based on intestinal metaplasia and epithelial dysplasia. It was a finding of intestinal metaplasia compared to all cases showing risk factors that require further clinical observation (follow-up) to detect potential malignancies earlier so that it is necessary to do more preventive action.

Expression of Friend Leukemia Integration-1 (Fli-1) and the Apoptosis Regulator B Cell Lymphoma-2 (BCL-2) in Gastric Carcinoma; an Immunohistochemical Study

ABSTRACT Fli-1 regulates multiple biological functions in different cancers particularly Ewing sarcoma and leukemias. There are controversial reports regarding function and prognostic significance of Fli-1 in epithelial cancer including gastric carcinoma (GC). No previous reports examined relationship between Fli-1 and BCL-2 in GC. This study aimed to investigate the expression of Fli-1 and BCL-2 in GC and expected the prognostic significance of their expression. Study was carried out on 88 gastric specimens (58 GC and 30 chronic gastritis cases). Immunohistochemical staining for Fli-1 and BCL-2 was done. There was significant lower Fli-1 and BCL-2 expression in GC than chronic gastritis. Advanced tumor stage showed significant relation with both low Fli-1 expression and negative BCL-2 expression. There was significant direct correlation between BCL-2 positivity and Fli-1 expression in GC. Cox-regression analysis showed that distant metastasis was the first independent factor affecting patients’ OS. Fli-1 could act as tumor-suppressor protein involved in GC carcinogenesis. In addition, both Fli-1 and BCL-2 may be used as good prognostic markers in GC. The direct correlation between BCL-2 and Fli-1 expression could potentiate Fli-1 and BCL-2 as therapeutic targets in GC, acting together to inhibit cellular proliferation.

Characteristics of gastric mucosa microbiota in children with chronic gastritis and duodenal ulcer

Objective: To investigate the differences of gastric mucosa microbiota between children with chronic gastritis and duodenal ulcer under the condition of Helicobacter pylori (Hp) infection. Methods: This prospective cohort study involved 57 children with Hp infection diagnosed by gastric endoscopy who were admitted to the Children's Hospital of Zhejiang University School of Medicine due to "abdominal pain, abdominal distension and vomiting" between January 2018 to August 2018. According to gastroscopy and pathological examination, the children were divided into chronic gastritis group and duodenal ulcer group. Gastric mucosa from Hp infected patients were sampled, and the flora DNA was analyzed by high-throughput sequencing. The statistical difference of α diversity, β diversity between two groups were analyzed. The relative abundance of the two groups in each taxonomic level was analyzed statistically. T test, Rank sum test or χ2 test was used for comparison between the two groups. Results: A total of 57 children diagnosed with Hp infection were enrolled in this study, including 42 cases of chronic gastritis (the age was (9.3±2.8) years, 22 males and 20 females) and 15 cases of duodenal ulcer (the age was (11.1±3.3) years, 9 males and 6 females). Alpha diversity index Chao and ACE in Hp infected chronic gastritis group were significantly higher than those in Hp infected duodenal ulcer group (217±50 vs. 183±64, t=2.088, P=0.009;218±47 vs. 192±76, t=1.566, P=0.016, respectively). The Beta-diversity index such as nonmetric multidimensional scaling (NMDS) analysis were significantly different in the two groups (analysis of similarity R=0.304, P=0.028). Among the main bacteria genera, there were 6 genera with significant differences between the two groups, which were Prevotella (0.190% (0.008%-1.983%) vs. 0.021% (0.005%-2.398%), Z=-2.537, P=0.011), Alloprevotella (0.097% (0.010%-0.813%) vs. 0.015% (0.003%-0.576%), Z=-2.492, P=0.013), Haemophilus (0.109% (0.004%-0.985%) vs. 0.014% (0.004%-0.356%), Z=-2.900, P=0.004), Neisseria (0.074% (0.004%-0.999%) vs. 0.024% (0.003%-0.255%), Z=-2.718, P=0.007), Streptococcus (0.166% (0.008%-1.869%) vs. 0.045% (0.006%-0.879%), Z=-2.537, P=0.010), and an unclassified-Microbacteriaceae (0.214% (0.060%-1.762%) vs. 0.117% (0.010%-0.954%), Z=-2.120, P=0.034). Linear discriminant analysis (LDA) effect sized analysis showed that at the genus level, only Prevotella was significantly enriched in the duodenal ulcer group (LDA=2.90, P=0.010), while Streptococcus, Neisseria and Haemophilus were significantly enriched in the chronic gastritis group (LDA=2.83, 2.82, 2.69, P=0.011, 0.007, 0.004, respectively). Conclusions: The gastric mucosal microbiota in duodenal ulcer associated with Hp is significantly different from that in chronic gastritis. Hp may promote the occurrence of peptic ulcer together with gastric microbiota.

Alterations in mucosa-associated microbiota in the stomach of patients with gastric cancer

PurposeThe purpose of this study was to characterize alterations in mucosa-associated microbiota in different anatomical locations of the stomach during gastric cancer progression and to identify associations between Helicobacter pylori infection and gastric microbial changes in patients with gastric cancer.MethodsTwenty-five H. pylori negative subjects with chronic gastritis and thirty-four subjects with gastric cancer were recruited, including H. pylori negative and positive patients with tumors in the antrum and the corpus. Gastric mucosa-associated microbiota were determined by 16S ribosomal RNA gene sequencing using a 454 sequencing platform.ResultsWe found that individuals with chronic gastritis from three different anatomical sites exhibited different microbiota compositions, although the microbial alpha diversity, richness and beta diversity were similar. Compared to patients with chronic gastritis, the gastric microbiota compositions were significantly different at the order level in the antrum and the corpus of patients with gastric cancer, which was dependent on the H. pylori infection status. Microbial alpha diversity and species richness, however, were similar between chronic gastritis and gastric cancer cases and independent of H. pylori status. The microbial community structure in patients with gastric cancer was distinct from that in patients with chronic gastritis. In addition, we found that the presence of H. pylori markedly altered the structure in gastric corpus cancer, but only mildly affected the antrum.ConclusionOur data revealed distinct niche-specific microbiota alterations during the progression from gastritis to gastric cancer. These alterations may reflect adaptions of the microbiota to the diverse specific environmental habitats in the stomach, and may play an important, as yet undetermined, role in gastric carcinogenesis.

PCR analysis and specific immunohistochemistry revealing a high prevalence of non-Helicobacter pylori Helicobacters in Helicobacter pylori-negative gastric disease patients in Japan: High susceptibility to an Hp eradication regimen.

The clinical significance of non-Helicobacter pylori Helicobacter (NHPH) is still unknown. There are many reports of NHPH-infected patients suffering from gastric diseases. Here, we investigated the polymerase chain reaction (PCR) positivity of NHPH infection in gastric disease patients who were negative for H.pylori (Hp) by the rapid urease test and by pathological observation. We collected the 296 endoscopically obtained gastric mucosal samples of Hp-negative gastric disease patients diagnosed based on a rapid urease test and pathology from 17 hospitals in Japan from September 2013 to June 2019, and we analyzed the existence of Hp and NHPH by PCR. The samples were also treated by indirect immunohistochemistry using an anti-Helicobacter suis VacA paralog antibody and were observed by confocal laser microscopy. Among the 236 non-Hp-eradicated cases, 49 cases (20.8%) were positive for NHPH. Among them, 20 cases were positive for Helicobacter suis, 7 cases were positive for Helicobacter heilmannii sensu stricto/ Helicobacter ailurogastricus (Hhss/Ha), and the other 22 cases could not be identified. The regional differences in the infection rates were significant. Forty percent of the nodular gastritis cases, 24% of the MALT lymphoma, 17% of the chronic gastritis cases, and 33% of the gastroduodenal ulcer cases were NHPH positive. Forty-five patients had been treated with one of the four types of combinations of a proton pump inhibitor and two antibiotics, and in all of these cases, the NHPH diagnosed by PCR was successfully eradicated. Immunohistochemistry using the Helicobacter suis-specific HsvA antibody coincided well with the PCR results. Among the 29 post-Hp eradication cases, three were NHPH positive, including one Hhss/Ha-positive case. Thus, approx. 20% of the Hp-negative non-Hp-eradicated gastric disease patients treated at 17 hospitals in Japan were infected with NHPH.