摘要
AIM: To determine the pattern of secreted mucin expression in Helicobacter pylori (H. pylori)-related, nonsteroidal anti-inflammatory drug (NSAID)-related and idiopathic gastric ulcers. METHODS: We randomly selected 92 patients with H. pylori-associated (n = 30), NSAID-associated (n = 18), combined H. pylori and NSAID-associated gastric ulcers (n = 24), and patients with idiopathic gastric ulcers (n = 20). Immunohistochemistry for T-cell CD4/CD8, andfor mucin 5AC (MUC5AC) and mucin 6 (MUC6), was performed on sections of the mucosa from the ulcer margin. Inflammation score was assessed according to the Sydney system. RESULTS: MUC5AC was expressed on the surface epithelium (98.9%) and neck glands (98.9%) with minimal expression in the deep glands (6.5%). MUC6 was strongly expressed in the deep glands (97.8%), variable in the neck glands (19.6%) and absent in the surface epithelium (0%). The pattern of mucin expression in idiopathic ulcer margins was not different from the expression in ulcers associated with H. pylori, NSAIDs, or combined H. pylori and NSAIDs. CD4/CD8 ratio was higher in H. pylori-positive patients (P = 0.009). Idiopathic ulcers are associated with hospitalized patients and have higher bleeding and mortality rates. CONCLUSION: Idiopathic ulcers have a unique clinical profile. Gastric mucin expression in idiopathic gastric ulcers is unchanged compared with H. pylori and/or NSAID-associated ulcers.
AIM： To determine the pattern of secreted mucin expression in Helicobacter pylori （H. pylori）-related, nonsteroidal anti-inflammatory drug （NSAID）-related and idiopathic gastric ulcers. METHODS： We randomly selected 92 patients with H. pylori-associated （n = 30）, NSAID-associated （n = 18）, combined H. pylori and NSAID-associated gastric ulcers （n = 24）, and patients with idiopathic gastric ulcers （n = 20）. Immunohistochemistry for T-cell CD4/CD8, andfor mucin 5AC （MUC5AC） and mucin 6 （MUC6）, was performed on sections of the mucosa from the ulcer margin. Inflammation score was assessed according to the Sydney system. RESULTS： MUC5AC was expressed on the surface epithelium （98.9%） and neck glands （98.9%） with minimal expression in the deep glands （6.5%）. MUC6 was strongly expressed in the deep glands （97.8%）, variable in the neck glands （19.6%） and absent in the surface epithelium （0%）. The pattern of mucin expression in idiopathic ulcer margins was not different from the expression in ulcers associated with H. pylori, NSAIDs, or combined H. pylori and NSAIDs. CD4/CD8 ratio was higher in H. pylori-positive patients （P = 0.009）. Idiopathic ulcers are associated with hospitalized patients and have higher bleeding and mortality rates. CONCLUSION： Idiopathic ulcers have a unique clinical profile. Gastric mucin expression in idiopathic gastric ulcers is unchanged compared with H. pylori and/or NSAID-associated ulcers.
基金
Beilinson Hospital Gastroenterology Department Trust Fund
