The Clinical Relevance And The Expression Of E-cadherin And EGFR Changes Between The Dilated Intercellular Space Of Gastroesophageal Reflux Disease And Patulous Cardia

Chapter Ⅰ The clinical relevance between the dilated intercellular space ofgastroesophageal reflux disease and patulous cardiaAim:To observe changes in intercellular space in the esophageal epithelium in patients with gastroesophageal reflux disease, and investigate the clinical relevance between the dilated intercellular space of gastroesophageal reflux disease and patulous cardiaMaterials and Methods:90 GERD patients and 20 normal controls were included in the study. GERD is diagnosed by both endoscopy and RDQ question. All of the patulous cardia cases were graded by endoscopy, and Specimens were taken from 2-3cm distant to Z line and stained with HE. The stained sections were observed and photographed under light microscopy. The intercellular space in the esophageal epithelium was measured by computer-assisted morphometry. One hundred measurements were performed in each case to calculate the mean intercellular space diameter.The data were analyzed to assess the correlation of the dilated intercellular space of gastroesophageal reflux disease and patulous cardia by SPSS 19.0.Results:1. The mean intercellular space diameters in GERD were significantly higher than that in normal controls (1.23±0.097μm vs0.81±0.044 μm; P<0.01); and the prevalence of the DIS in patients with GERD was increased compared with the normal controls, the difference was statistically significant (χ2= 6.62, P<0.05).2. The rates of patulous cardia in the patients with GERD were significantly lower than that in normal controls (P< 0.01); and the proportion of DIS in GERD patients with patulous cardia were also higher than that in GERD patients with no patulous cardia, the difference was statistically significant (χ2= 5.61, P<0.05).3. In GERD patients with normal cardia, the proportion of chest pain were significantly increased, and heartburn proportion were also high in the patients with DIS; but the difference of reflux symptoms were not statistically significant; in the GERD patients with the absence of DIS change, patients with a cardiac relaxation occurred reflux symptoms significantly higher than that in the GERD patients with non-patulous cardia, and the difference of the symptoms of chest pain and heartburn was no statistically significant.4. The symptoms of chest pain, heartburn and regurgitation in GERD with DIS and accompanied by patulous cardia were significantly higher than those in GERD with no DIS and patulous cardia, the difference was statistically significant (P<0.05).Conclusion:DIS and patulous cardia were common in patients with GERD, and the rates of DIS in the GERD with patulous cardia were higher, and the clinical symptoms was more pronounced, indicated that patulous cardia and DIS may be the mportant factors in the onset of GERD.Chapter Ⅱ Expression of E-cadherin and EGFR changes in the intercellular space in the esophageal epithelium in patients with GERDAim:To investigate the distribution and expression of E-cadherin and EGFR and observe changes in the esophageal epithelium in patients with GERD and Patulous cardia.Materials and Methods:90 GERD patients and 20 normal controls were included in the study. GERD is diagnosed by both endoscopy and RDQ question; and Specimens were taken from 2-3cm distant to Z line and stained with HE. Immunohistochemistry was used to examine the distribution and expression of E-cadherin and EGFR in the esophageal epithelium in these patients. The stained sections were observed and photographed under light microscopy. The intercellular space in the esophageal epithelium was measured by computer-assisted morphometry. One hundred measurements were performed in each case to calculate the mean intercellular space diameter.Semi-quantitative integral method was used to determine a positive result. The spss19.0 was used to statistical analysis.Results:1. The mean intercellular space diameters in GERD were significantly higher than that in normal controls (1.23±0.097μm vs0.81±0.044 μm; P<0.01); and the prevalence of the DIS in patients with GERD was increased compared with the normal controls, the difference was statistically significant(χ2= 6.62, P<0.05).2. The expression of EGFR in GERD group were significantly higher than that in normal controls; and the expression of EGFR in GERD with DIS were significantly higher than that in GERD with no DIS. They showed an obviously positive correlation (r= 0.35, P< 0.05).3. The expression of E-cadherin in GERD group were significantly lower than that in normal controls; and the expression of E-cadherin in GERD with DIS were significantly lower than that in GERD with no DIS. They showed an obviously negative correlation (r=-0.18, P< 0.05).4. In the GERD with DIS, the expressions of E-cadherin were significantly lower and the expressions of EGFR were significantly higher. They showed an obviously negative correlation (r=-0.28, P< 0.05).Conclusion:E-cadherin shows diminished expression and EGFR shows the strong expressions, and altered distribution in the esophageal epithelium in patients with gastroesophageal reflux disease. Aberrant expression of E-cadherin and EGFR may involve in the onset of the DIS in GERD, be become the tag of GERD.