幽门螺杆菌根除对不同胃黏膜病变环氧合酶-2表达的影响

Effect of H pylori eradication on COX-2 expression in two entities of gastric mucosal pathological changes

目的探讨Hpylori根除对慢性浅表性胃炎和萎缩肠化胃黏膜上皮细胞COX-2表达的影响。方法采用快速尿素酶试验和组织学碱性品红染色法检测胃黏膜Hpylori感染状况;应用免疫组织化学法检测胃黏膜上皮细胞COX-2的表达。结果17例Hpylori阳性慢性浅表性胃炎中11例见不同程度胃黏膜上皮细胞COX-2阳性表达,Hpylori根除后6例COX-2表达消失,2例减弱,2例无改变,1例增强,前后对照差异有显著性(P<0.05)。同时Hpylori根除后12例胃黏膜慢性炎症见不同程度减轻,与COX-2表达变化有较好相关性(P<0.05)。10例Hpylori感染萎缩性胃炎伴肠化生者9例COX-2表达阳性,Hpylori根除后1、2a复查COX-2表达减弱5例,消失2例,1例无变化,1例增强,前后对照差异有显著性(P<0.05),但胃黏膜组织学对照无明显改善。结论根除Hpylori可消除慢性浅表性胃炎胃黏膜上皮细胞COX-2表达,且与慢性炎症程度消退相关。而根除Hpylori虽可减弱萎缩肠化胃黏膜上皮细胞COX-2表达,但不能改善胃黏膜萎缩和肠化状态。

[Objective] To study the effect of H pylori eradication on COX-2 expression of gastric mucosal epithelia in chronic superfacial gastritis and chronic atrophic gastritis with intestinal metaplasia. [Methods] Rapid urease test and basic magnenta dyeing assay were used to assess the status of H pylori infection in the stomach. Expression of COX-2 was detected immunohistolochemically. [Results] In 17 cases of H pylori related superficial gastritis COX-2 expressed in 11 cases, among which after H pylori eradication COX-2 expression disappeared in 6 cases, decreased in 2 cases, unchanged in 2 cases, and increased in 1 case. Scores of chronic inflammation in gastric mucosa decreased to some extent in 12 cases. 9 out of 10 cases of chronic gastritis with intestinal metaplasia were positive in COX-2 expression.1-2 years after H pylori eradication COX-2 expression disappeared in 2 cases, decreased in 5 cases, unchanged in 1 case, and increased in 1 case. However, there was no significant change in mucosal histopathological status. [Conclusion] Eradication of H pylori could eliminate COX-2 expression in epithelia of chronic superficial gastitis,which is correlated with amelioration of chronic inflammation. Otherwise, Eradication of H. pylori can decrease COX-2 expression in epithelia of chronic atrophic gastitis with metaplasia, but can not improve the status of gastric atrophy and intestinal metaplasia