The Study Of White Vinegar Staining In The Common Endoscopy Combined With Cdx2 , Muc2 Detect For The Value In The Diagnosis Of Gastric Intestinal Metaplasia.

Objective To investigate the value of white vinegar staining in the common endoscopy combined with CDX2 , MUC2 detect in the diagnosis of gastric intestinal metaplasia. Methods (1) 139 patients with normal endoscopic diagnosis of atrophy gastritis, superficial gastritis and suspected cancer were enrolled.1.5% white vinegar was sprayed on the antrum and lower gastric body mucous of these patients. After the white vinegar staining, the changes of mucosal morphology were observed, and the biopsy samples were taken from the obviously changed area and detected the CDX2 and MUC2 expression by the technique of immunohistochemical. For the gastric mucous which did not change significantly ,we took biopsy samples conventionally. Results (1) 82 cases were chronic arophic gastritis, 55 of which were with obvious gastric mucosal"white effect"and 27 cases without. 52 cases were chronic superficial gastritis, 5 of which were with obvious gastric mucosal"white effect"and 47 cases without.4 of 5 cases which were suspected cancer had obvious gastric mucosal"white effect".(2)HE pathology combined with white vinegar staining shows: the diagnosis of 82.7% cases of chronic superficial gastritis by HE pathology was in accordance with the diagnosis by normal endoscopy; the diagnosis of 67.0% case of atrophic gastritis was in accordance with the diagnosis by normal endoscopy.②There was obvious gastric mucosal"white effect"in the 50 cases from 56 cases with gastric intestinal metaplasia. The number of the patients with"white effect"of gastric intestinal metaplasia group was more than the superficial gastritis group's and atrophic gastritis group's. There was significantly statistical difference between them.③The gastric pits of patients with gastric intestinal metaplasia were typeⅣmainly, and 2 of these patients are typeⅢ. The gastric pits of patients with atrophic gastritis were also typeⅣmainly.There was no statistical difference between them. The main gastric pits of patients of superficial gastritis were typeⅡ, and of gastric cancer were typeⅥ. (3)The test of immunohistochemistry shows:①The positive incidence of the expression of CDX2 and MUC2 in the group with obvious"white effect"was higher than the group without. P <0.05.There was significantly statistical difference between them.②The positive incidence of the expression of CDX2 and MUC2 in the group with gastric intestinal metaplasia was higher than those groups without gastric intestinal metaplasia—atrophic gastritis group and superficial gastritis group. P <0.05.There was significantly statistical difference.③T he diagnosis rates of intestinal metaplasia by the positive expression of CDX2 and / or MUC2 combined with obvious"white effect"(97.1%) was higher than the diagnosis rates of intestinal metaplasia by HE pathology combined with obvious"white effect"(83.4%). Conclusion (1) The gastric mucosal with obvious"white effect"and the mucosal pits with pathologic typeⅣchanges were the performance of gastric mucosal intestinal metaplasia or dysplasia, which were consistent with the expression of MUC2,CDX2.(2)The gastric mucous with obvious"white effect"after white vinegar staining under common gastroscopy can be used as a basis for the diagnosis of intestinal metaplasia;.(3) White vinegar staining combined with the detect of MUC2 and CDX2 can raise the diagnostic rate of gastric mucosal intestinal metaplasia.