Chronic Gastritis Group Research Articles

Psychoanalysis of 300 patients with chronic gastritis

Objective To analyze the difference of psychosocial characteristics in patients with chronic gastritis. Methods From June to December 2018, a total of 300 patients with chronic gastritis visited Xijing Hospital were consecutively enrolled. The patients were divided into chronic non-atrophic gastritis (CNAG) group, chronic atrophic gastritis (CAG) group and CAG with intestinal metaplasia group, with 100 cases in each group. Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), living events scale (LES) and Eysenck personality questionnaire (EPQ) were used for evaluation and analysis. Chi square test, analysis of variance, nonparametric rank sum test and Kruskal Wallis H test were used for statistical analysis. Results The incidences of anxiety of the CAG group and the CAG with intestinal metaplasia group were both significantly higher than that of the CNAG group (64.0%, 64/100; 53.0%, 53/100; and 34.0%, 34/100; respectively), and the differences were statistically significant (χ2=0.007 and 0.001, both P 56.7) of etraversion or introversion and concealment in CAG group and the CAG with intestinal metaplasia group were higher than those in the CNAG group (48.0%, 48/100; 23.0%, 23/100; 4.0%, 4/100 and 46.0%, 46/100; 21.0%, 21/100 and 7.0%, 7/100, respectively), and the differences were statistically significant (χ2=0.001, 0.001, 0.001 and 0.004, all P<0.01). Conclusions Anxiety is associated with CAG and intestinal metaplasia, while depression is associated with intestinal metaplasia. In male patients and patients under 50 years old, depression, negative event and high psychiatric stress are more significantly related to intestinal metaplasia. The mental characteristics of extroversion, emotional instability, psychoticism and concealment are closely associated with CAG. Key words: Chronic gastritis; Atrophy; Intestinal metaplasia; Psychological characteristic; Mental characteristic

Toll-like receptor 9 polymorphisms and Helicobacter pylori influence gene expression and risk of gastric carcinogenesis in the Brazilian population.

BACKGROUNDToll-like receptors (TLRs) are the first line of host defense, and are involved in Helicobacter pylori (H. pylori) recognition and activation of both inflammatory and carcinogenic processes. The presence of single nucleotide polymorphisms (SNPs) in genes that activate the immune response may modulate the risk of precancerous lesions and gastric cancer (GC). Among them, Toll-like receptor 9 (TLR9) polymorphisms have emerged with a risk factor of infectious diseases and cancer, however the studies are still inconclusive.AIMTo evaluate whether TLR9 rs5743836 and rs187084 SNPs contribute to the risk of gastric carcinogenesis, and its influence on mRNA expression.METHODSA case-control study was conducted to evaluate two TLR9 SNPs (TLR9-1237 TC-rs5743836 and TLR9-1486 CT-rs187084) in chronic gastritis (CG) and GC patients. A total of 609 DNA samples of peripheral blood [248 CG, 161 GC, and 200 samples from healthy individuals (C)] were genotyped by polymerase chain reaction-restriction fragment length polymorphism. All samples were tested for the H. pylori infection using Hpx1 and Hpx2 primers. Quantitative polymerase chain reaction by TaqMan® assay was used to quantify TLR9 mRNA from fresh gastric tissues (48 GC, 26 CG, and 14 C).RESULTSFor TLR9-1237, the TC + CC or CC genotypes were associated with a higher risk of GC than C [recessive model odds ratio (OR) = 5.01, 95% confidence interval (CI): 2.52-9.94, P < 0.0001], and the CG (recessive model OR =4.63; 95%CI: 2.44-8.79, P < 0.0001) groups. For TLR9-1486, an association between the CT + TT genotypes and increased risk of both GC (dominant model OR = 2.72, 95%CI: 1.57-4.72, P < 0.0001) and CG (dominant model OR = 1.79, 95%CI: 1.15-2.79, P = 0.0094) was observed when compared to the C group. Moreover, the presence of TLR9-1237 TC/CC + TLR9-1486 CC genotypes potentiate the risk for this neoplasm (OR = 18.57; 95%CI: 5.06-68.15, P < 0.0001). The TLR9 mRNA level was significantly higher in the GC group (RQ = 9.24, P < 0.0001) in relation to the CG group (RQ = 1.55, P = 0.0010) and normal mucosa (RQ = 1.0). When the samples were grouped according to the polymorphic genotypes and the presence of H. pylori infection, an influence of TLR9-1237 TC + CC polymorphic genotypes (P = 0.0083) and H. pylori infection (P < 0.0001) was observed on the upregulation of mRNA expression.CONCLUSIONOur findings show that TLR9 rs5743836 and rs187084 polymorphisms are associated with a higher risk of carcinogenesis gastric, and that TLR9 mRNA levels can be modulated by TLR9-1237 TC + CC variant genotypes and H. pylori infection.

Analysis on the specificity of the relevant points along the governor vessel in chronic gastritis based on tenderness reaction and tenderness threshold

To explore the specificity of the relevant points along the governor vessel in chronic gastritis through the synchronous observation of the tenderness reaction and tenderness threshold on the back along the governor vessel in the volunteers with chronic gastritis and make the comparison with healthy volunteers. A chronic gastritis group and a healthy volunteer group were prepared, 30 cases in each one. Using synchronous comparison, the tenderness reaction at the point inferior to each of the spinous processes from T1 to L3 along the governor vessel was observed. The mechanical pressure pain threshold was determined. Regarding the tenderness reaction at the point inferior to each spinous process on the back along the governor vessel, the occurrence rate was different significantly between the chronic gastritis group and the healthy volunteer group (P<0.01). The tenderness threshold at the point inferior to each spinous process from T1 to L3 along the governor vessel in the chronic gastritis group was lower than the healthy volunteer group, the tenderness thresholds from T4 to T9 and T12 were different significantly between the two groups (P<0.01, P<0.05). The tenderness reaction at the point inferior to each spinous process on the back along the governor vessel presented the significant negative correlation with the tenderness threshold in the chronic gastritis group (P<0.01), and the correlation was not displayed in the healthy volunteer group (P>0.05). The point inferior to the spoinous process of T4 on the governor vessel, Shendao (GV 11, T5) and Lingtai (GV 10, T6) are the points with the high specificity in chronic gastritis, which provides the reference to clinical treatment with acupuncture and moxibustion. The occurrence rate of high tenderness reaction and the low tenderness threshold may be the important manifestation of the point specificity on the back along the governor vessel in chronic gastritis.

Significance of Serological Gastric Biopsy in Different Gastric Mucosal Lesions: an Observational Study.

Screening and timely treatment of precancerous gastric cancer diseases or of gastric cancer in the early stages has important significance in reducing the incidence and mortality of gastric cancer. Gastroscopy and histopathological biopsy are still the gold standards for the diagnosis of gastric diseases. But the application of astroscopy for the screening and diagnosis of gastric diseases is limited. In recent years, serum pepsinogen (PG), gastrin, and Helicobacter pylori (H. pylori) IgG antibodies have become indicators for "serological biopsy" of the gastric mucosa. From January 2016 to January 2018, a total of 2,394 patients with digestive tract symptoms underwent gastroscopy. According to the endoscopic examination and pathological diagnosis, there were four case groups: 1,376 cases of chronic non-atrophic gastritis, 708 cases of chronic atrophic gastritis, 265 cases of gastric ulcer, and 45 cases of gastric cancer. Serological gastric biopsies were performed and analyzed. The serum levels of PGI in the chronic atrophic gastritis group was significantly lower than that in the chronic non-atrophic gastritis group, gastric ulcer group, and gastric cancer group (p < 0.05). The serum levels of PGII and G-17 in the gastric cancer group were significantly higher than those in the chronic non-atrophic Gastritis group, chronic atrophic gastritis group, and gastric ulcer group (p < 0.05). The PGR in the gastric cancer group was significantly lower than that in the chronic non-atrophic gastritis group, chronic atrophic Gastritis group, and gastric ulcer group (p < 0.05). The H. pylori positive rates in the chronic atrophic gastritis group and gastric cancer group were higher than those in the chronic non-atrophic gastritis group and gastric ulcer Group (p < 0.05). Serological gastric biopsy is closely correlated to gastric mucosal disease and can be used as a Screening tool in gastric disease.

Prevalence of &amp;lt;i&amp;gt;Helicobacter pylori cag&amp;lt;/i&amp;gt;A and &amp;lt;i&amp;gt;sab&amp;lt;/i&amp;gt;A Genotypes in Patients with Gastric Disease

Gastric cancer is one of the most common types of cancer worldwide. Helicobacter pylori is considered one of the most important causes of this condition specially because of its virulence markers as sabA and cagA. Therefore, we aim to investigate the relation between these markers and the gastric diseases in 400 patients who underwent upper digestive endoscopy. To detect the bacteria and its genes by Polymerase Chain Reaction (PCR), the presence of H. pylori was significant when comparing the groups control vs. cancer (p value vs. chronic gastritis (p value cagA was statistically significant considering its presence when comparing the chronic gastritis vs. cancer groups (p value = 0.0434) OR [95% CI] 2.44 (1.021 - 5.845). Associating both sabA and cagA, we found a statistically significant result (p value vs. cancer groups. Helicobacter pylori is directly associated to gastric diseases such as gastritis and cancer and its virulence markers: sabA and cagA increase the injury process to the gastric epithelium making the host more susceptible to cancer.

Immunohistochemical evaluation of P53 and Ki67 in biopsy samples of gastritis and gastric cancer patients

Background: Chronic gastritis (CG) is an inflammatory process that can lead to gastric cancer and Helicobacter Pylori (H. Pylori). In this study, immunohistochemical evaluation of P53 and Ki67 in biopsy samples of CG and gastric carcinoma patients with and without H. Pylori infection was investigated. Methods: From 82 archived paraffin blocks, 42 blocks were selected for CG group and 40 as the gastric cancer group. All CG and gastric cancer cases were subdivided into H. Pylori positive and negative subgroups. Monoclonal antibodies specific for Ki67 and P53 were used for immunohistochemical staining. Results: The results showed that differences of Ki67 and P53 expressions were statistically significant among patients with CG gastritis and gastric cancer (P 0.05). Conclusions: The present study proposed that P53 and Ki67 expressions changed in gastric cancer compared to the CG specimens. It seems that overexpression of these biomarkers probably has important roles in the route of carcinogenesis. Our results suggested that these overexpressions were not associated with H. Pylori infection. Further studies with larger sample size are needed in this field.

Blood flow differences in cun-kou (radial) artery and anterior tibial artery: normal people vs patients with chronic gastritis

OBJECTIVETo explore the blood flow differences in cun-kou (radial) artery and anterior tibial artery between normal people and patients with chronic gastritis METHODSUsing doppler ultrasonography, blood flow charts [peak systolic velocity (VP), maximum blood flow velocity in diastole (VD), mean blood flow velocity (VM), pulse index (PI), resistance index (RI), blood vessel diameter (D), vessel volume (SV), circulation blood flow periodic time (ET)] measured by at cun-kou (radial) artery and anterior tibial artery in normal group (n = 30) and chronic gastritis group (n = 30) in department of ultrasound, Beijing Anzhen hospital, capital medical university. RESULTSIn the doppler flow charts of the normal group, there were statistically significant differences in VD, VM, D, RI, SV, ET between cun-kou artery and anterior tibial artery (P < 0.05), and there were more statistically significant differences in PI between cun-kou artery and anterior tibial artery (P < 0.01). In the comparison of doppler flow charts in the chronic gastritis group, there were statistically significant differences in VD, VM, D, RI, SV, ET between cun-kou artery and anterior tibial artery (P < 0.05), and there were more statistically significant differences in PI between cun-kou artery and anterior tibial artery (P < 0.01). In the comparison of doppler flow charts between normal group and chronic gastritis group, there were statistically significant differences in SV, ET between normal group and chronic gastritis group (P < 0.05), and there were more statistically significant differences in PI between normal group and chronic gastritis group (P <0.01). CONCLUSIONBased on the differences in doppler flow charts between the normal group and the chronic gastritis group, the doppler flow charts of cun-kou artery and anterior tibial artery were not only proved to be significantly different, but also provided quantitative objective indexes for the study of cun-kou artery and anterior tibial artery doppler flow charts of normal people and chronic gastritis patients. This study also proves that the doppler flow chart of the anterior tibial pulse is of great significance for the diagnosis of chronic gastritis.

Detection of DNA H.pylori and distribution of CagA genotype in cancerous and precancerous tissue

Helicobacter pylori (H. pylori) has been recognized as the causative agent of chronic gastric inflammation, which can progress further to a variety of diseases such as peptic ulcer and adenocarcinoma. The major bacterial virulence markers of H. pylori, the cytotoxin-associated gene (CagA), may play a role in determining the clinical outcome of Helicobacter infections. Aim of this study to investigate the presence of H.pylori DNA within gastric epithelial cells in patients with H.pylori infection and to determine the prevalence of CagA among patients with cancerous and precancerous lesion. Methods: A total of 92 gastric biopsy samples, 25 H.pylori negative and 67 H.pylori positive patients. H.pylori DNA in gastric epithelial cells and CagA gene of H. pylori was assessed by using the in situ hybridization test. Results: In H. pylori positive group, the positive rates of H.pylori DNA in the gastric epithelial cells were progressively increased in chronic superficial gastritis, precancerous changes and gastric cancer groups(P&gt;0.01); The detection of CagA positive H. pylori was significantly higher in patients with gastric cancer compared to those with chronic superficial gastritis and atrophic gastritis(P&lt;0.01). Conclusion: The pathological progression from chronic superficial gastritis, precancerous changes to gastric cancer is associated with higher positive rates of H.pylori DNA presence in the gastric epithelial cells, and there was a significant increase in CagA-positive H.pylori among patients with gastric cancer

A multi-center clinical research of diagnostic value of serum gastrin-17 combined with pepsinogen for gastric cancer

Objective To evaluate the diagnostic value of gastrin-17(G-17) and pepsinogen(PG) for gastric cancer. Methods A multicenter cross-sectional study of patients with continuous stomach discomfort from four centers including Changhai Hospital Affiliated to Second Military Medical University, the First Hospital Affiliated to Anhui Medical University, Qinghai Provincial People′s Hospital and the First Hospital Affiliated to Zhejiang University of Chinese Medicine from May 2014 to September 2015 was conducted. Before gastroscopy, fasting serum gatrin-17 and pepsinogen were analyzed by enzyme-linked immunosorbent assay(ELISA). The efficacy of G-17 and PG were evaluated according to endoscopic and pathological results. Results Based on the results of the pathological diagnosis, 1 122 cases were enrolled and divided into chronic atrophic gastritis group(548 cases), chronic non-atrophic gastritis group(370 cases), and gastric cancer group(204 cases). Serum G-17 and PGⅡ levels significantly increased(P 7 pmol/L and PGR 7 pmol/L and PGⅡ>10 μg/L was regarded as the cut-off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 48.04%, 79.74%, 73.98%, 34.51% and 87.35% respectively. If PGR 10 μg/L was regarded as the cut-off value, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 33.82%, 84.86%, 75.58%, 33.17% and 85.23% respectively. Based on logistic regression analysis of the independent variables of high serum G-17 value(>7 pmol/L), low serum PGR value( 10 μg/L), their OR value were 2.592, 2.237 and 1.864 respectively, and high serum G-17 value showed the highest risk of gastric cancer. Conclusion High serum G-17 and PGⅡ, low PGR are indicators of gastric cancer. Combination of G-17 and PGR has the best diagnostic value for gastric cacer. Gastric cancer can be screened in large scale by combining G-17 and PGR in order to improve the early diagnostic rate of gastric cancer and reduce the mortality of gastric cancer in our country. Key words: Stomach neoplasms; Diagnosis; Multicenter study; Pepsinogens; Gastrin-17

Increased Red Blood Cell Volume Distribution Width: Important Clinical Implications in Predicting Gastric Diseases.

The red blood cell distribution width (RDW) is a blood analyzer marker showing the peripheral blood erythrocyte volume heterogeneity parameters. It is a normal diagnosis index of many diseases. This study was performed to evaluate the relationship between the RDW and gastric diseases. A total of 189 patients with GC, 68 patients with gastric ulcers, 92 patients with chronic gastritis, and 157 healthy controls were enrolled in this study. Each patient's RDW and other biomarkers were recorded. All of the statistical analyses and comparisons between each group were determined using SPSS16.0 software. The statistical significance level was set to a p-value < 0.05. The RDW was significantly higher in those patients with gastric diseases when compared to the control group (p < 0.05). In addition, the RDW was independently correlated with the presence of GC and gastric ulcers. Significantly positive correlations between the RDW, platelets, and platelet distribution width (PDW) were observed in those patients with GC and gastric ulcers, although there were negative correlations with the red blood cells (RBCs), hemoglobin, and mean corpuscular volume (MCV) (p < 0.05). In the chronic gastritis group, elevated RDW values were closely associated with the hemoglobin, platelet, and MCV values (p < 0.05). The specificities of the gastric diseases groups were greater than 90%. In cases of gastric diseases, the RDW values were increased and were associated with several laboratory parameters. These finding may have important clinical implications in predicting gastric diseases.

Prevalence of &amp;lt;i&amp;gt;Helicobacter pylori vacA&amp;lt;/i&amp;gt;, &amp;lt;i&amp;gt;cagA&amp;lt;/i&amp;gt;, &amp;lt;i&amp;gt;dupA&amp;lt;/i&amp;gt; and &amp;lt;i&amp;gt;oipA&amp;lt;/i&amp;gt; Genotypes in Patients with Gastric Disease

Gastric diseases such as chronic gastritis and gastric cancer are most commonly caused by virulence factors of Helicobacter pylori (H. pylori), such as the vacA, cagA, dupA and oipA genes. Therefore, this study investigated the prevalence and the combination of these virulence factors from patients with gastric diseases. The endoscopic biopsies were obtained from 516 patients with gastric symptoms, 101 of which were from patients with normal gastric tissue, 365 of which were from patients with chronic gastritis, and 50 of which were from patients with gastric cancer. H. pylori and the virulence factors were detected by PCR. The oipA gene exhibited an increased risk for chronic gastritis (p = 0.0296), and the vacA gene demonstrated a risk for gastric cancer from chronic gastritis (p = 0.0002). Based on the combination of the virulence factors, cagA, vacA, dupA and oipA genes exhibited a high prevalence in patients with chronic gastritis and gastric cancer. The cagA+/dupA+ genotype demonstrated a significant correlation in patients with normal gastric mucosa (p = 0.0278). In the chronic gastritis group, a significant association was observed between the cagA+ and the vacA s1m1 genotypes (p cagA+/dupA+ genotypes (p = 0.0183), the dupA+/oipA+ genotypes (p cagA, vacA, dupA, and oipA genes, which contributed to the risk of developing gastroduodenal diseases. Furthermore, this is the first study to reveal a high prevalence of the oipA gene in H. pylori isolates in Brazil.

The importance of TH22 and TC22 cells in the pathogenesis of Helicobacter pylori-associated gastric diseases.

An association exists between Helicobacter pylori (H. pylori), peptic ulcers, gastritis, and sometimes gastric carcinomas. Th22 cells have protective and inflammatory roles in defense against microbes. We investigated the frequencies of Th22, Tc22, Th22/17, and Tc22/17 cells in addition to the changes in levels of cytokines IL-22, IL-6, IL-23, TNF-α, IL-1β, and TGF-β in sera from patients with H. pylori-associated gastritis, and peptic ulcer, and in uninfected patients. A total of 76 patients with H. pylori-associated disorders formed the studied group. Frequencies of T-cell subsets were determined by flow cytometry. Levels of cytokines IL-22, IL-6, IL-23, TNF-α, IL-1β, and TGF-β in the sera and supernatants of patients were measured by ELISA and flow cytometry. The study participants included 32 males and 44 females with a mean age of 38.5±15.3years. We divided the infected group into peptic ulcer and gastritis (mild, moderate, active chronic, and chronic). The frequencies of Th22, Tc22, and Tc22/17 increased significantly in the peptic ulcer, moderate, active chronic, and chronic gastritis groups compared to the uninfected group. Th22/17 only increased significantly in the chronic gastritis group. We observed significant increases in IL-22 in the moderate and active chronic gastritis, IL-23 in the active chronic and chronic gastritis, and TNF-α in the peptic ulcer and moderate gastritis groups. Following in vitro antigenic stimulation, we observed significantly higher levels of IL-1β, IL-23, and IL-6 in the active chronic gastritis group, as well as IL-6 and IL-1β in the chronic gastritis group compared to the uninfected group. Increased Th22, Tc22, and Tc22/17 cells and IL-22 levels appear to be influential in progression and severity of H. pylori infection. Th22/17 can be an interesting therapeutic target for chronic H. pylori infections where eradication is more difficult.

Prevalence of Helicobacter pylori cagA, vacA, and iceA genotypes in children with gastroduodenal diseases

To investigate the prevalence of cagA, vacA, and iceA genotypes in the isolated strains of Helicobacter pylori (H.pylori) from children with gastroduodenal diseases in Jiangxi, China, as well as the association between cagA, vacA, and iceA genotypes and the type of gastroduodenal diseases. The samples of gastric antral mucosa were collected from 316 children with gastroduodenal diseases in Jiangxi, and a total of 107 strains of H.pylori were isolated. The genomic DNA of these strains was extracted, and PCR was used to determine the ureA, cagA, vacA, and iceA genotypes. Of all the 107 isolated strains of H.pylori, the detection rates of ureA and cagA genes were 100% (107/107) and 94.4% (101/107) respectively. The overall detection rate of vacA gene was 100% (107/107), and the detection rates of vacAs1a, vacAs1c, vacAm1, and vacAm2 genes were 74.8% (80/107), 25.2% (27/107), 29.9% (32/107), and 69.2% (74/107) respectively, with both vacAm1 and vacAm2 genes detected in 0.9% (1/107) of all H.pylori strains. In the chimera of vacA gene, the detection rates of vacAs1a/m1, vacAs1a/m2, vacAs1c/m1, and vacAs1c/m2 genes were 26.2% (28/107), 51.4% (55/107), 3.7% (4/107), and 17.8% (19/107) respectively (P<0.001). The detection rates of iceA1 and iceA2 genes were 79.4% (85/107) and 9.3% (10/107), respectively (P<0.001), and both iceA1 and iceA2 genes were detected in 7.5% (8/107) of all strains. The detection rates of the genotypes of H.pylori showed no significant differences between the peptic ulcer, chronic gastritis, and duodenal bulbar inflammation groups (P>0.05). The dominant genotypes of H.pylori are cagA, vacAs1a/m2, and iceA1, and there are mixed infections with H.pylori strains of different genotypes in children with gastroduodenal disease from Jiangxi, China. The genotypes of H.pylori are not associated with the type of gastroduodenal disease.

Clinical significances of the CD14brightCD16bright cell subset in peripheral blood of patients with gastric cancer

Objective To study the clinical significances of CD14brightCD16bright cell subset in peripheral blood of patients with gastric cancer (GC). Methods The CD14brightCD16bright cells in peripheral blood samples collected from 124 patients with gastric cancer (GC), 130 patients with chronic gastritis (CG) and 80 normal healthy controls (HC) were measured by using flow cytometry. Differences in the CD14brightCD16bright cells between different groups were analyzed with the Mann-Whitney U test. The feasibility of using CD14brightCD16bright cells as a potential biomarker for differentiating GC patients from CG was assessed by using the receiver operating characteristic (ROC) curve analysis. Correlations between the CD14brightCD16bright cells and clinicopathologic parameters of GC were analyzed with multivariate correlation analysis. Results The percentages of CD14brightCD16bright cells in peripheral blood samples and in CD14bright monomuclear cells collected from the patients with GC [median: 0.38% (0.23%-0.52%) and 6.61% (4.23%-9.56%)] were significantly higher than those of the CG and HC groups [median: 0.11% (0.07%-0.15%) and 5.08% (3.35%-6.42%); median: 0.05% (0.03%-0.07%) and 5.09% (4.20%-7.40%)] (P<0.01). The area under the ROC curve for CD14brightCD16bright cells in the peripheral blood was 0.934 (95%CI: 0.900-0.968) indicating that the value of CD14brightCD16bright cells in the diagnosis of GC was much higher than that of alpha fetoprotein (AFP), cacino-embryonic antigen (CEA) and carbohydrate antigen CA199. The area under the ROC curve for combined multi-markers by using logistic model (CD14brightCD16bright cell subset and serum tumor markers) was 0.947 (95%CI: 0.920-0.973). The CD14brightCD16bright cells were closely associated with lymphocyte cells (P<0.01). Conclusion The CD14brightCD16bright cells were dramatically increased in the peripheral blood of patients with gastric cancer, which could be used as a biomarker in the diagnosis of gastric cancer. Key words: Mononuclear cell; Gastric cancer; CD14brightCD16bright cell subset

Helicobacter pylori infection in Lhasa People's Hospital from 2009 to 2013

Objective To investigate the infection status of Helicobacter pylori (Hp) in a Lhasa hospital. Methods A retrospective survey of Hp infection from 2009 to 2013 was conducted in Lhasa People's Hospital. The data of 14C-urea breath test and gastroscopy were analyzed. Results A total of 2 908 patients were enrolled, 1 518 (52.20%) were Hp positive, including 1 061 males (1 061/1 939, 54.72%) and 457 females (457/969, 47.16%). The Hp infection rate in males was higher than that in females (χ2=14.788, P= 0.000). The Hp infection rate by years from 2009 to 2013 was 55.97%(267/477), 49.79%(239/480), 54.66%(375/686), 52.06%(291/559) and 49.15%(347/706), respectively. The infection rate in 2013 was significantly lower than that in 2009 and 2011 (P=0.021, 0.040). There were no significant differences in Hp infection rates among Tibetan, Han and Hui ethnic groups. In 2020 cases who underwent endoscopic examination, 1 098 had Hp positive (54.36%). The Hp infection rate in chronic superficial gastritis group(39.91%) was significantly lower than that in erosive gastritis (χ2=30.143, P=0.000), gastric ulcer (χ2=22.434, P=0.000), gastric polyps (χ2=9.627, P=0.002), gastric cancer (χ2=9.506, P=0.002), duodenal ulcer (χ2=54.158, P=0.000), duodenitis (χ2=14.966, P=0.000) and compound ulcer groups (χ2=8.582, P=0.003). The Hp infection rate in duodenal ulcer group(68.42%) was significantly higher than that in chronic superficial gastritis (χ2=54.158, P=0.000), erosive gastritis (χ2=6.733, P=0.009), atrophic gastritis (χ2=21.496, P=0.000) and gastric ulcer groups (χ2=8.940, P=0.003). Conclusion Hp infection rate appears a decreasing trend in Lhasa area in last 5 years; among various gastro-duodenal diseases patients with duodenal ulcer have a highest Hp infection rate. Key words: Helicobacter pylori; Gastrointestinal diseases; Retrospective studies

The influence of cytokine gene polymorphisms on the risk of developing gastric cancer in patients with Helicobacter pylori infection.

BackgroundHelicobacter pylori infection is the main cause of gastric cancer. The disease progression is influenced by the host inflammatory responses, and cytokine single nucleotide polymorphisms (SNPs) may have a role in the course of the disease. The aim of our study was to investigate proinflammatory cytokine polymorphisms, previously associated with the development of gastric cancer, in a Slovenian population.Patients and methods.In total 318 patients and controls were selected for the study and divided into three groups: (i) patients with gastric cancer (n = 58), (ii) patients with chronic gastritis (n = 60) and (iii) healthy control group (n = 200). H. pylori infection in patient groups was determined by serology, histology and culture. Four proinflammatory gene polymorphisms were determined (IL-1β, IL-1ra, TNF-α, TLR-4) in all subjects.ResultsWe found a statistically significant difference between males and females for the groups (p = 0.025). Odds ratio (OR) for gastric cancer risk for females was 0.557 (95% confidence interval [CI]: 0.233–1.329) and for chronic gastritis 2.073 (95% CI: 1.005–4.277). IL-1B-511*T/T homozygous allele for cancer group had OR = 2.349 (95% CI: 0.583–9.462), heterozygous IL-1B-511*T had OR = 1.470 (95% CI: 0.583–3.709) and heterozygotes in TNF-A-308 genotype for chronic gastritis had OR = 1.402 (95% CI: 0.626–3.139). Other alleles had OR less than 1.ConclusionsWe could not prove association between gastric cancer and chronic gastritis due to H. pylori in any cytokine SNPs studied in Slovenian population. Other SNPs might be responsible besides infection with H. pylori for the progression from atrophy to neoplastic transformation.

Influence of functional polymorphisms in TNF-α, IL-8, and IL-10 cytokine genes on mRNA expression levels and risk of gastric cancer.

Functional polymorphisms in promoter regions can produce changes in the affinity of transcription factors, thus altering the messenger ribonucleic acid (mRNA) expression levels of inflammatory cytokines associated with the risk of cancer development. The goal of this study was to evaluate the influence that polymorphisms in the cytokine genes known as TNF-α-308 G/A (rs1800629), TNF-α-857 C/T (rs1799724), IL-8-251 T/A (rs4073), IL-8-845 T/C (rs2227532), and IL-10-592 C/A (rs1800872) have on changes to mRNA expression levels and on the risks of chronic gastritis (CG) and gastric cancer (GC). A sample of 723 individuals was genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Relative mRNA expression levels were measured using quantitative real-time PCR (qPCR). Polymorphisms TNF-α-308 G/A and IL-8-251 A/T were not associated with risks of these gastric lesions. However, TNF-α-857 C/T, IL-8-845 T/C, and IL-10-592 C/A were found to be associated with a higher risk of GC, and IL-10-592 C/A was found to be associated with a higher risk of CG. The relative mRNA expression levels (RQ) of TNF-α, IL-8, and IL-10 were markedly downregulated in the CG group (median RQs = 0.128, 0.247, and 0.614, respectively), while the RQ levels of TNF-α in the GC group were upregulated (RQ = 2.749), but were basal for IL-8 (RQ = 1.053) and downregulated for IL-10 (RQ = 0.179). When the groups were stratified according to wild-type and polymorphic alleles, only for IL-8-845 T/C the polymorphic allele was found to influence the expression levels of this cytokine. IL-8-845 C allele carriers were significantly upregulated in both groups (GC and CG; RQ = 3.138 and 2.181, respectively) when compared to TT homozygotes (RQ = -0.407 and 0.165, respectively). In silico analysis in the IL-8 promoter region revealed that the presence of the variant C allele in position -845 is responsible for the presence of the binding sites for two transcription factors (REL and CREB1), which are involved in increased gene expression. Polymorphic alleles were not shown to have any effect on the expression levels of TNF-α and IL-10. Taken together, our findings provide evidence for an association of TNF-α-857 C/T, IL-8-845 T/C, and IL-10-592 C/A with a higher risk of gastric cancer and also demonstrate the influence that the polymorphic C allele of IL-8-845 has on changes to the gene expression levels of this cytokine.

Diagnosis value of membrane glycolipids biochemistry index in intracranial and gastrointestinal tumors.

The diagnostic value of membrane glycolipid biochemistry index, the lipid-bound sialic acid (LSA) and total sialic acid (TSA) in cerebrospinal fluid (CSF) was evaluated in 30 intracranial and 65 gastrointestinal tumors. The plasma LSA, TSA and red cell membrane sialic acid (R-SA) in were determined according to the method of Sevenmerhulm. Our results showed that the levels of LSA and TSA in CSF of intracranial tumor patients was higher than that of normal group(p<0.01). The concentration of TSA and LSA in patients with malignant glioma was higher than that of benign meningioma patients(P<0.01). No significance was found between intracranial halmatoma patients and normal control group for levels of membrane glycolipids (p>0.05). Results also found that the plasma LSA, TSA and R-SA of gastric carcinoma were significantly higher than those of control group (p<0.05); while no significant difference was found in the plasma LSA, TSA and R-SA levels between chronic gastritis, gastrohelcoma and normal control group (p>0.05). Plasma LSA, TSA and R-SA levels of gastric carcinoma patient were significantly higher than those of chronic gastritis patients and gastrohelcoma patients(p<0.05). It was also found that plasma LSA, TSA and R-SA contents were significantly higher in large intestine carcinoma patients than in benign in stestine tumor patients (p<0.05) while no significant difference was found between intestine benign tumor and normal control group (p>0.05). The levels of LSA, TSA and R-SA were obviously higher in the patients with metastasis than in the ones without (p<0.05.) The membrane glycolipid biochemistry index LSA and TSA in CSF are sensive markers for diagnosing intracranial tumors. For gastrointestinal malignant tumors the plasma LSA TSA and red blood cell membrane SA may be considered as auxiliary indicators for diagnosis. They can be used for distinguishing benign from malignant tumors.

Determination of urinary 5-hydroxyindoleacetic acid as a metabolomics in gastric cancer.

The aim of this paper is to study urinary5-hydroxyindoleacetic acid (5-HIAA) in gastric cancer patients with a biochemical method and compare this metabolite with normal control and individuals with chronic gastritis. The subjects were 48 histologically proven gastric adenocarcinoma patients. They were 10 women and 38 men with mean age of 63.73 years. For determination of urinary excretion of 5-HIAA, a biochemical method was applied. According to kit protocol, the patients' fresh urine was added to the reagent material, and the color of the sediment that was the result of interaction between 5-HIAA and the mercury salt was compared with the standard colorimetric plate of the kit. The same method was also performed for a group of 47 patients with chronic gastritis and also a group of 50 normal individuals (age and sex matched). Urinary 5-HIAA was significantly higher in gastric cancer patients compared to individuals with chronic gastritis and normal controls (P value <0.001), but no association was detected in urinary 5-HIAA based on age, sex, or site of tumor and tumor grade in gastric cancer patients group. Also, no significant difference was noted in 5-HIAA excretion between chronic gastritis and normal control groups. Urinary excretion of 5-HIAA is significantly higher in the gastric cancer patients in comparison with that of chronic gastritis patients or normal individuals. So, this test could be regarded as a tumor marker in conjunction with other modalities in diagnosis of gastric cancer.

Associations of a TLR4 single-nucleotide polymorphism with H. pylori associated gastric diseases in iranian patients

Helicobacter pylori (H.pylori) is associated with gastric ulcer and gastric adenocarcinoma. Polymorphisms in the host genes coding for toll-like receptors (TLRs) may influence the innate and adaptive immune response to the infection, affecting the susceptibility to H.pylori or the disease outcomes. But the details and association to different polymorphisms and different clinical expressions in patients infected with H.pylori (different clinical expression of H.pylori infection) remain unclear. A case-control study consisting of 195 patients with H.pylori infection and 241 H.pylori uninfection was conducted. Genomic DNA was extracted and genotypes of TLR4Asp299Gly polymorphism were assessed through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Presence of cagA was evaluated using PCR. TLR4 (Asp299Gly) G and DG alleles frequency in H.pylori infected population was significantly higher in the chronic gastritis group than in the chronic active gastritis group (P=0.021; OR, 2.409; 95% CI, 1.124-5.162). Grade mononuclear (MN) infiltration in H.pylori infected patients with DG genotype of TLR-4 Asp299Gly increased significantly. CagA positivity was more frequently associated with chronic active gastritis (P=0.017, OR=2.26, 95% CI=1.144-4.462) and grade polymorphonucler (PMN) infiltration. TLR-4 Asp299Gly G allele substitution may be modified pattern of immune response in the gastric mucosa of H.pylori infected patients and may be H.pylori infected patients with gastritis have increased risk for the development of chronic gastritis. CagA positivity may be a risk factor for development of gastritis.