环氧合酶-2在小儿慢性炎症胃黏膜中的表达

The expression of cyclooxygenase-2 in gastric mucosa of children with chronic gastritis

目的探讨小儿时期不同炎症胃黏膜环氧合酶-2(COX-2)表达特点及可能意义。方法随机抽取正常胃黏膜、普通慢性胃炎、幽门螺杆菌(Hp)相关慢性胃炎、慢性胃炎伴肠上皮化生(无Hp 感染)共110例蜡块重新切片作常规病理学评估,并应用免疫组化法分析胃黏膜 COX-2表达。结果 COX-2在正常胃黏膜无表达;普通胃炎组9例轻度表达(22.5%);Hp 胃炎组27例轻度表达(67.5%),中度表达2例(5.0%);肠化组轻度表达6例(30.0%)。Hp 相关胃炎较普通胃炎组及肠化组(均为轻度炎症)COX-2阳性率细显著升高(P=0.000和 P=0.002);普通胃炎组中重度炎症 COX-2阳性率较轻度炎症高(P=0.025)。慢性胃炎伴肠化组和普通胃炎组炎症程度无差别(P=0.527),其 COX-2阳性表达率一致(P=0.542)。结论小儿胃炎 COX-2表达较弱,Hp 感染可诱发 COX-2表达,其表达率随炎症程度加重而升高,COX-2表达和肠化无关。小儿早期轻度表达 COX-2,其生理意义可能与成人有所不同。

Objective Aim Cyclooxygenase-2 is expressed in patients with Helicobacter pylori-associated gastritis. How it expresses and influences human has not been elucidated completely. This study identiffed the expression of COX-2 in children with H. pylori infection or chronic gastritis. Methods Gastric biopsies from 110 subjects were enrolled, 10 cases from normal children, 40 cases of chronic superficial gastritis （ CSG）, 40 cases of CSG with H. pylori infection, 20 cases of gastric mucosal intestinal metaplasia （IM） without H. pylori infection. Histopathological evaluation was performed again and the expression of COX-2 in human gastric mucosa was detected by immunohistochemical staining. Results COX-2 had never been detected in normal specimens. The positive of COX-2 was 22. 5% in CSG, 72.5% in H. pylori infected CSG and 30. 0% in IM, almost all of them were weak. In the mild gastritis, the expression of COX-2 in patients with H. pylori infection was significantly higher than that in CSG and IM without H. pylori infection （P = 0. 000 and P =0. 002）. The level of COX-2 in moderate-marked inflammation was higher than that in mild among CSG （P =0. 025）. No difference was found between CSG and IM with either inflammation or COX-2 （P = 0. 527 and P = 0. 542）. Conclusion COX-2 expression induced by H. pylori infection and inflammation in gastric mucosa, it is not correlated with IM. In children, the expression of COX-2 was weak, and the function is different from adults.