Expression Of Ki67and Regâ…£ In Different Morphologic Atrophic Gastritis With Intestinal Metaplasia Gastric Mucosa

Background and ObjectivesGastric cancer is a kind of the common gastrointestinal malignancies, and its morbidity is high. The early symptoms and abnormal morphology of gastric mucosa are absent or not typical, so that diagnosis of early gastric cancer is very difficult, and often is missed. Most of patients are diagnosed in advanced stage, so it’s difficult to obtain an satisfactory five-year survival rate. There is a poor prognosis with most patients at present. The incidence of stomach cancer will be reduced if early prevention and regular endoscopic examination can be done in high-risk patients.This test is designed to infer which morphologic change in gastric antrum mucosa has more probability to develop into dysplasia or cancer to improve accuracy rate of gastric biopsy by detecting the expressions of Ki67and RegⅣ in different morphologic atrophic gastritis with intestinal metaplasia gastric mucosa, according to morphology, pathology and molecular biology of gastric antrum mucosa,Subjects and MethodsA total of314gastric antrum biopsy specimens of different lesions and morphologic changes of gastric mucosa, including60nonatrophic gastritis (NAG),61 atrophic gastritis (AG),64atrophic gastritis with intestinal metaplasia displaying superficial depressed mucosa lesions (DIM),64atrophic gastritis with intestinal metaplasia displaying superficial elevated mucosa lesions (EIM) and65gastric cancer (GC) were gathered. All of the patients did not receive medical treatment, such as proton pump inhibitors or protective agent of gastric mucosa.The expressions of Ki67and RegⅣ were detected by immunohistochemistry and reverse transcriptase-polymerase chain reaction.ResultsThe positive rates of Ki67protein in NAG, AG, DIM, EIM, GC were gradually increased. The positive rates were15.0%,18.0%,23.4%,70.3%,70.8%. There were significant differences between EIM and DIM, NAG, AG (P<0.05), while there was no difference between EIM and GC. The expression of Ki67was much higher in EIM than that in DIM. The expressions of Ki67mRNA were0.19±0.02,0.28±0.01,0.60±0.02,1.17±0.04,1.35±0.03in NAG, AG, DIM, EIM, GC. The statistical results of Ki67mRNA were as the same as the protein’s.The positive rates of REGIV protein in NAG, AG, DIM, EIM, GC were11.7%,26.2%,42.2%,92.2%,29.2%. The expression of REGIV was significantly higher in EIM than that in NAG, AG, DIN and GC (P<0.05). The expression of RegⅣ mRNA were0.37±0.03,0.49±0.01,1.03±0.03,1.33±0.01,0.70±0.01. The statistical results of RegⅣ reverse transcriptase-polymerase chain reaction were as the same as the immunohistochemistry.ConclusionsThe expressions of Ki67and RegⅣ are significantly higher in EIM than those in DIM. So, maybe there is more chance of EIM developing into dysplasia or cancer than DIM. Maybe it’s better to take EIM for gastric biopsy in high-risk patients.