Associations Of Helicobacter Pylori Infection With Chronic Inflammation And Proliferation In Local Cardiac Mucosa In High-risk Group Of Cardiac Carcinoma In Chaoshan Region

Backgrounds and objectivesThere is now a general consensus that the persistent infection of H. pylori is one of the unambiguous etiological factors of chronic gastritis, peptic ulcer (including both gastric ulcer and duodenal ulcer) and low grade mucosa-associated lymphoid tissue (MALT) lymphoma. The persistent infection may be a promoter factor in the occurrence process of gastric cancer. In 1994, H. pylori was classified as a member of first class carcinogenic factor by WHO. There are no detailed mechanisms of H. pylori inducing the initiation of gastric carcinoma that are satisfactory and acceptable widely in spite that H. pylori is in the catalogue of first class carcinogen. It is quite certain that the malignant neoplasm in distal end of stomach is positively correlated with H. pylori. The cardiac of stomach,the anatomical junction of the esophagus and the corpus gastricum, has different epithelium and tissue structure and pH environment. So investigating the infection status and the clump density of H. pylori in the cardiac mucosa and determining the correlation of occurrence of cardiac carcinoma with the persistent infection in cardiac mucosa in the further studies are well needed.In this study, we confirmed the diagnosis of the cardiac mucosa and the severity of the chronic inflammation in the tissue sections stained by HE stain. Then we investigated the infection status of H. pylori in high-risk population of cardiac cancer in Chaoshan region through the Giemsa stain that was improved by water-bath heating and immunohistochemistry stain. Then we classified the infection status by the clump density of H. pylori colonization. Furthermore, we reckoned the expression level of nuclear associated antigen Ki-67 in the sections stained by IHC. Revealing the associations of infection status and the clump density of H. pylori with the degree of chronic inflammation and the proliferation in the cardiac mucosa will provide a few evidences for uncovering the relations of H. pylori with the initiation and development of cardiac cancer. Subjects and methodsWe investigated the infection status of H. pylori and determine the grade of clump density of H. pylori by the Giemsa stain that was improved by water-bath heating and immunohistochemistry in formalin-fixed, paraffin-embedded gastric cardiac tissues sections from 334 patients with histological diagnoses of the normal and simple chronic carditis (n=258), chronic carditis with atrophy (n=40) and chronic carditis with dysplasia (n=36). The whole were divided into two groups: one was of patients with symptoms(n=234) and another was of subjects without symptoms who were examined in the screening for esophagus carcinoma or gastric cardiac carcinoma (n=100). The expression level of Ki-67 was assessed by immunohistochemistry and then quantified by calculating a labeling index (LI).In the end, we analyzed the data in appropriate statistical methods.Results1. The epidemiological characteristic of Helicobacter pylori: the overall prevalence is 76.9%(257/334). There was a significant difference on the prevalence between the patients with gastritis complaints( 81.2%,190/234)and the endoscopic survey residents ( 67.0%,67/100). The infection rate of the chronic carditis group was much higher than carditis negative group(P<0.01). Meanwhile, both the age and the gender did not correlated with Helicobacter pylori infection(P>0.05).2. The correlations of the H. pylori clump density, the severity of chronic carditis and the degree of expression of Ki-67: Both the grade of chronic carditis and the expression of Ki-67 strongly correlated with the H. pylori clump density(P<0.01).3. The prevalence and the clump density of H. pylori correlated with pathologic types of the normal and chronic carditis, chronic carditis with dysplasia and chronic atrophic carditis(P<0.05). Conclusions1. The prevalence of the H. pylori in high-risk group of cardiac carcinoma in Chaoshan region was much higher than the overall infection rate in China(59%)and the chronic carditis group was much higher than carditis negative group.2. The infection of H. pylori induced the chronic carditis, and the grade of the chronic carditis varied with the clump density of H. pylori.3. The prevalence and the clump density of H. pylori correlated with pathologic types of the normal and chronic carditis, chronic carditis with dysplasia and chronic atrophic carditis.