Musashi-1and CDX2Expression In Different Forms Of Gastric Mucosa Damage

Background and ObjectivesGastric cancer is one of the most common malignant tumors in the world; itsmortality rate is very high, only second to lung cancer in China. It’s a seriousthreatens to human health. With the development of endoscopic techniques, themicroscopic structure of intestinal metaplasia of gastric mucosal lesions can be cleardisplayed by using narrow-band imaging magnifying endoscopy (NBI-ME), whichhas been paid great attention by endoscopic physicians and widely used in theendoscopic examination. But the research of molecular biology related in intestinalmetaplasia of gastric mucosal lesions is very less at present.By researching at different forms of gastric mucosal damage in combinationwith pathology and molecular biology by using narrow band imaging magnifyingendoscopy,this text was designed to detect the expressions of Musashi-1and CDX2in different types of intestinal metaplasia gastric mucosa of antrum in precancerouslesions and cancers tissue, analyze the correlation between different forms ofintestinal metaplasia and gastric cancer, and decide which type of intestinalmetaplasia are more likely to be malignant transformation so as to provide the basisfor clinical diagnosis, treatment and prevention.Subjects and MethodsGastroscopy images recorded by NBI-ME retrospectively were collected and analysised,343diagnosis cases were included in total, the specimens of which wereselected from the gastric antrum.36chronic non-atrophic gastritis（CNAG）,52focalelevated intestinal metaplasia（FEIM）,68verrucous elevated intestinal metaplasia（VEIM）,48“cotton wool” intestinal metaplasia（CWIM）,36low intraepithelialneoplasia（LIN）,32early gastric cancer（EGC）. Choose the specimens From Aug,2012to May,2013for double immunofluorescence labeling.10chronic non-atrophicgastritis（CNAG）,13focal elevated intestinal metaplasia（FEIM）,17verrucouselevated intestinal metaplasia （VEIM）,12“cotton wool”intestinal metaplasia（CWIM）,12low intraepithelial neoplasia（LIN）,7early gastric cancer（EGC）.Musashi-1and CDX2protein of original tissue paraffin blocks which meet thestandard were detected by immunohistochemistry; The co-expression of Musashi-1and CDX2protein were detected by double immunofluorescence labeling; Theintestine metaplasia is divided into typesⅠ,Ⅱand Ⅲ by HID-AB-PAS stainingmethod.ResultsThe positive rates of Msi-1protein of the gastric mucosal biopsy specimensfrom CNAG, FEIM, VEIM, CWIM,LIN and EGC were25%,69.2%,76.4%,75%,80.5%,84.4%, respectively; the positive rates of CDX2protein were13.9%,76.9%,79.4%,75%,61.1%,34.3%in the above groups respectively; the comparativedifferences between CNAG and other groups had statistically significance (P<0.05)The expression of double immunofluorescence labeling: there weren’t Msi-1+CDX2+expression in CNAG, Msi-1+CDX2+coexpression respectively in FEIM,VEIM, CWIM, LIN and EGC tissues were:41.36±11.88,43.71±12.67,42.75±12.68,56.35±13.97,28.71±7.52(F=5.872, P=0.001); the comparative differences amongeach Intestinal metaplasias and LIN, EGC had statistically significance.The positive expression rates of Msi-1in typesⅠ,Ⅱand Ⅲ intestinal metaplasiawere60.7%、80%、80.7%(P<0.05)respectively.The positive expression rates of CDX2in typesⅠ,Ⅱand Ⅲ intestinal metaplasia were89.2%,73.3%,69.2%(P<0.05)respectively;Msi-1+CDX2+coexpression in typesⅠ,Ⅱand Ⅲ intestinal metaplasiawere:33.78±10.55,43.81±10.08,51.03±2.74(F=9.817,P=0.000). Pairwise comparisonsbetween each samples showed:comparative differences between typesⅠ,Ⅱand Ⅲ had statistically significant (P<0.05), comparative differences between typeⅡandⅢhad no statistically significant (P>0.05).ConclusionsMsi-1,CDX2and Msi-1+CDX2+expressions have no relationship with the threeforms of intestinal metaplasia mucosa; The co-expressions of Msi-1+and CDX2+maybe one of the most important mechanisms of transformation process of intestinalmetaplasia into the gastric mucosa neoplasia.