liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Characterization of the gastric cardia in volunteers from the general population: type of mucosa, helicobacter pylori infection, inflammation, mucosal proliferative activity, p53 and p21 expression, and relations to gastritis
Pathology Research Department, Ryhov Hospital, Jönköping, Sweden and Department of Pathology, Karolinska University Hospital, Stockholm, Sweden.
Department of Pathology, Medical Centre Hospital, Örebro, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences.
2010 (English)In: Digestive Diseases and Sciences, ISSN 0163-2116, E-ISSN 1573-2568, Vol. 55, no 1, 46-53 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this research was to characterize the mucosa of the gastric cardia in relation to infection with Helicobacter pylori and the occurrence of chronic gastritis in other parts of the stomach in a sample of the general population. In this study, 80 adult volunteers underwent esophagogastroscopy with biopsies from the gastric cardia, corpus, and antrum. Gastritis was classified according to the Sydney system. Chronic gastritis (cardia excepted) was diagnosed in 35 subjects, 30 with Hpylori infection. Epithelial proliferative activity (Ki-67), p53- and p21 expression were examined quantitatively with cell counting after immunohistochemical stainings. Esophagitis was diagnosed macroscopically. Fourty eight subjects had cardia-type and 32 corpus-type mucosa in the anatomical cardia. The prevalence of esophagitis (nine cases) did not differ between these groups. Carditis was more prevalent among subjects with cardia-type mucosa (73 vs. 28%, P < 0.0001). Hpylori was present in 48% of those with cardia-type and 25% of those with corpus-type mucosa (P = 0.06). Of the 44 subjects with carditis, 31 had Hpylori in this location. The group with Hpylori infection had significantly higher mucosal proliferative activity when compared to uninfected subjects. Among the subjects with H. pylori-associated carditis, more p53-positive epithelial cells were detected compared to both the non-infected group (P = 0.0004) and to subjects with non-Hpylori-associated carditis (P = 0.03). In subjects with cardia-type mucosa, and both carditis and gastritis, the degree of chronic inflammation was higher in the cardia compared to the corpus and antrum and the p53 expression was significantly higher in the cardia compared to the corpus, but similar to that in the antrum. The proliferative activity was significantly higher in the antrum compared to the cardia and corpus, respectively. In conclusion, H. pylori infection, carditis, and increased p53 expression are more common in subjects with cardia- than corpus-type mucosa in the gastric cardia. Carditis is mainly related to Hpylori infection. There are some differences regarding inflammation, proliferative activity, and p53 expression between the cardia and other regions of the stomach, yet the significance of these differences remains to be clarified.

Place, publisher, year, edition, pages
2010. Vol. 55, no 1, 46-53 p.
Keyword [en]
Cardia, Carditis, Gastritis, Helicobacter pylori, Proliferation, Ki-67, p53, p21
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-53693DOI: 10.1007/s10620-008-0705-0OAI: oai:DiVA.org:liu-53693DiVA: diva2:291262
Available from: 2010-02-01 Created: 2010-02-01 Last updated: 2017-12-12
In thesis
1. Chronic gastritis in a sample of the general population: Helicobacter pylori infection, metaplastic transformation, epithelial proliferation, p53- and p21 expression and antral mucosal gastrin content with reference to gastric carcinoma development
Open this publication in new window or tab >>Chronic gastritis in a sample of the general population: Helicobacter pylori infection, metaplastic transformation, epithelial proliferation, p53- and p21 expression and antral mucosal gastrin content with reference to gastric carcinoma development
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Infection with H. pylori is the main cause of chronic inflammation in the stomach. lt is strongly associated with benign ulcer disease and a risk factor for gastric carcinoma (GC). Different tophographical types of gastritis bear different risks for future development of GC. Mucosal changes, atrophy and intestinal metaplasia (IM) are known precancerous conditions.

The aims of this thesis were to map out the prevalence of chronic gastritis, including different tophographical types, carditis and H. pylori infection in an adult Swedish general population sample. To determine the prevalence of atrophy and different types of IM and measure the mucosal proliferative activity (Ki-67), expression of p53 and p21 with immunohistochemistry. Furthermore, to determine plasma levels of gastrin and the content of G-cells in the antrum with immunohistochemistry measured with three different morphometrical methods.

The prevalence of chronic gastritis was 50%. lt was associated with H. pylori infection in 87%. The prevalence of carditis was 55% and it was associated with local H. pylori infection in 70%. The most common type of gastritis was antrum predominant (44%) followed by pangastritis (37%) and corpus predominant (19%). The prevalence of atrophy (antrum and/or corpus) was 55% and it increased with age, as did the prevalence of IM, which was present in the antrum or corpus in 23% and in the cardia in 10%. Corresponding figures for the prevalence of type III IM was 4% and 1%, repspectively. In all locations there was a strong correlation between the occurrence of IM and both H. pylori infection and chronic inflammation. Chronic inflammation and H. pylori infection were associated with increased mucosal proliferation and expression of p53. Atrophy as well as IM were associated with increased expression of p53 in both the corpus and antrum. IM was associated with increased proliferation in the mucosa, as was atrophy in the corpus. The expression of p21 was low and not affected by infection or inflammation. Plasma levels of gastrin were increased in subjects with H. pylori infection and showed no correlation with the amount of antral G-cells. The three different methods for G-cell quantification correlated poorly.

In conclusion,chronic gastritis and carditis in this sample of an adult Swedish general population were frequent and strongly associated with H. pylori infection. The prevalences of different gastritis types and mucosal changes associated with increased cancer risk were determined and the relationships between chronic gastritis/carditis and both increased mucosal proliferation and expression of p53 in all parts of the stomach were established. Increased plasma levels of gastrin among subejects with H. pylori infection were established, as was the lack of a correlation between circulating gastrin levels and the amount of G-cells in the antrum. Poor correlations between three different methods for G-cell quantification highlight a methodological problem.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2004. 85 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 855
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-23315 (URN)2744 (Local ID)91-7373-831-X (ISBN)2744 (Archive number)2744 (OAI)
Public defence
2004-09-24, Aulan, Länssjukhuset, Ryhov, Jönköping, 10:00 (Swedish)
Opponent
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2012-10-31Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Authority records BETA

Petersson, FredrikFranzén, Lennart EBorch, Kurt

Search in DiVA

By author/editor
Petersson, FredrikFranzén, Lennart EBorch, Kurt
By organisation
SurgeryFaculty of Health Sciences
In the same journal
Digestive Diseases and Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 128 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf