Effects Of EGF And EGFR On Prognosis Of Reflux Esophagitis Patients

ObjectiveThis study investigated the change of the EGF in reflux esophagitis patients'saliva and blood serum. It evaluated the clinical effects of EGF and EGFR on esophageal mucosa repair and prognosis of esophagitis. It also studied the effect of Geranylgeranylacetone on reflux esophagitis and analyzed its possible mechanism.MethodPatients with reflux esophagitis at Sir Run Run Shaw Hospital from Feb.2010 to Dec 2010 were recruited for this study. Patients were randomly treated with Rabeprazole (Group A) and both Rabeprazole and Gerany lgeranylacetone(Group B) for eight weeks.Group C was a control group. The symptoms of patients were rated and saliva and blood serum were collected every two weeks after treatement.Biopsy of esophageal lesions was carried out in the first week and eighth week by gastroscopy. Group C only had gastroscopy with esophageal biopsies. EGF serum levels and EGF salivary concentration were determined by ELISA and the EGFR expression in esophageal mucosa determined by Immunohistochemistry.ResutlsThere were 49 subjects in the experimental group and 17 subjects in the control group. From the second week the symptoms were all relieved. The cure rates in the second week were 75.0% in GroupA (16/18)and 100% in Group B(20/20). There was a significant difference between the two groups (P<0.01). However, such difference disappeared in the examination in week 4, week6 and week 8.38 patients had gastroscopy re-examination in week 8. The cure rate in Group A was 88.9%(16/18) and the cure rate in Group B is 100%(20/20). There was no statistically significant difference between the two. The serum EGF of group A in WeekO,week 2,Week 4,week 6 and week 8 were(Meam±SEM) 277.9±57.4,272.3±53.7,257.7±64.5,247.1±57.3,261.2±39.1 (pg/ml), group B were (Mean±SEM) 296.5±54.8,337.5±64.8,284.1±46.3,324.0±56.9,352.0±39.7 (pg/ml), There was no significant difference between the two groups. The saliva EGF of group A in week 0,week 2,Week 4,week 6 and week 8 were (Meam±SEM) 1466±302,1651±329,1380±244,1182±219,1319±240(pg/ml)and group B were (Mean±SEM) 1221±158,1246±198,1293±292,1105±157,1107±144 (pg/ml). EGFR expression was significantly higher in experimental group than in the control group (P=0.005<0.05), after treatment EGFR expression was lowered. There was statistically significant difference between Before and after treatment(P<0.05), but no statistically significant difference between Group A and B.ConclusionThere was no significant change in saliva and blood serum during reflux esophagitis treatment. EGFR expression was significantly higher in experimental group than in control group, but after treatment EGFR expression was lowered. EGFR plays an important role in the development and prognosis of esophagitis. Geranylgeranylacetone can speed up the symptom relief, but whether the mechanism is through the promotion of the EGF and EGFR expression needs further research.