| With the improvement of people’s health consciousness and the wideusages of endoscopic techniques, gastric polypoid lesions of detection rate hasbeen higher. These lesions may be true epithelial polyps, heterotopias,lymphoid tissue, or stromal lesions.Gastric polyps refers to benign protuberantlesions which localized at gastric normal epithelial tissues. Hyperplasticpolyps and fundic gland polyps are the most common types of gastric polyp.The patient usually has no characteristic symptoms, sometimes showedvarying degrees of gastrointestinal symptoms, such as abdominal discomfort,early satiety, abdominal distension, serious person can appear gastrointestinalbleeding, obstruction and so on, even malignancy. Because of the increasingincidence of gastric polyps, and the various complications and the risk tocancer aroused the interest of many scholars at home and abroad, and maderelevant research.But there was still no uniform opinion for the pathogenesisof gastric hyperplastic polyps and gastric fundic gland.Combined with domestic and foreign reports, this experiment analyzedgastric juice and polyps tissues that patients with fundic gland polyps50cases,hyperplastic polyps26cases and normal control group20cases, and tried tofind out the possible pathogenesis of fundic gland and hyperplastic polyps.The experiment was divided into two parts:Part I The content of bile acid and pH on gastric juice of Fundic glandpolyps and Hyperplastic polyps and their significanceObjective：To detect bile acid and pH value of gastric juice, and toexplore the significance for fundic gland polyps and hyperplastic polyps.Methods：1CasesTo collect the patents who were found gastric polypoid lesions by endoscopic examination between March2011to May2012in People HospitalAffiliated to Hebei Medical University,5-10ml gastric juice in gastric mucouslake was extracted with disposable catheter, then polyps tissue were taken forpathological examination. The samples from those patients who werediagnosed as fundic gland polyp(50cases) and hyperplastic polyps(26cases)were selected out as the experimental group. In addition,5-10ml gastric juicefrom people who with negative sign in endoscope was extracted, as negativecontrol group, a total of20cases. All samples were sealed and freezed in a-20℃refrigerator, waiting to check.2Parameters detection2.1Each sample of pH was detected by precision pH meter after thawinggastric juice to20-25℃.2.2After gastric juice were centrifuged for10minutes in3500r/min, thecontent of bile acid each supernatant sample was detected by using automaticbiochemical analyzer.3Statistical analysisStatistics software of edition SPSS17.0was used for data analysis. Thenormal data was expressed as mean±SEM and non-normal date wasexpressed as percentiles. The data was assessed statistically using one-wayanalysis of variance (ANOVA) and nonparametric test. Statistical significancewas set at P <0.05.Results：1All subjects were96cases, male38, female58, age range20-85years,mean age52.19±14.09years old.There were no significant difference ingender and age among three groups.2Fundic gland polyp group: mean pH was2.68±1.25; the25%percentile of bile acid was2.08μ mol/L,the median(50%percentile) was7.10μ mol/L,75%percentile was28.58μ mol/L.3Hyperplastic polyp group: mean pH was3.80±1.73; the25%percentileof bile acid was2.85μ mol/L,the median(50%percentile) was7.05μ mol/L,75%percentile was29.78μ mol/L. 4The control group: mean pH3.54±0.83; the25%percentile of bileacid was2.43μ mol/L,the median(50%percentile) was5.60μ mol/L,75%percentile was28.65μ mol/L.5pH of fundic gland polyp group was lower than that of control group,statistical comparison P=0.920>0.05, the statistic consequences was nostatistical significance; the level of bile acid was higher than that of controlgroup, statistical comparison P=0.889>0.05, the consequence was notsignificant statisticlly.6pH of hyperplastic polyp group was higher than that of control group,statistical comparison P=0.430>0.05, the statistic consequences was nostatistical significance; the level of bile acid was higher than that of controlgroup, statistical comparison P=0.861>0.05, the consequence was notsignificant statisticlly.7Compared to hyperplastic polyp group, pH of gastric juice in fundicgland polyp group was lower, statistical comparison P=0.234>0.05, thestatistic consequences was no statistical significance; the level of bile acid infundic gland polyp group was higher than that of hyperplastic polyp group,statistical comparison P=0.343>0.05, the consequence was not significantstatisticlly.Summary：1The pH of fundic gland polyp group was lower than that of controlgroup, but the differences were no statistical significance; pH of hyperplasticpolyp group was higher than control group, the consequence was no statisticalsignificance, which showed two kinds of possibility:the first,samples were notbig enough so as to affect the exact results, the second: pH value of gastricjuice has no influence on fundic gland polyps and hyperplastic polyp.2Bile acid of gastric juice in the fundic gland polyp group andhyperplastic polyp group were both higher than those of control group, butdifferences had no statistical significance. which showed two kinds ofpossibility: the first: the few number of samples affecting the results; thesecond there was really no influence between pH value and the fundic gland polyps and hyperplastic polyps.3The relationship between the bile acid and pH of gastric juice andfundic gland polyps and hyperplastic polyps formation and growth was notvery clear.PartⅡ The expression of β-catenin,MUC6on fundic gland polyps andhyperplastic polyps and their significanceObjective：To detect the expression of β-catenin protein and MUC6ingastric fundic gland polyps and gastric hyperplastic polyps, to explore thesignificance between β-catenin protein and MUC6and fundic glandpolyps,hyperplastic polyps.Methods：1Cases1-2blocks of polyps’ tissue biopsy were taken as experimental group, and1block normal mucosa next to typical polyps was taken as control group. Allspecimens were fixed by10%formalin and embedded by paraffin, then HEstaining were tested after conventional treatment. Fundic gland polyps,hyperplastic polyps and normal gastric mucosa tissue were made sure. Afterscreening, all specimens were numbered and saved for the test. Ultimately96samples were obtained and divided into three groups: fundic gland polypgroup50cases, hyperplastic polyp group26cases, control group20cases.2Immunohistochemistrythe expression level of β-catenin protein and MUC6of all specimenswere detected by immunohistochemical method The labeling was scored forboth the extent and the intensity. The extent was recorded semiquantitativelyas the percentage of the cells that showed labeling: negative (<10%of thecells), focal (10%to50%of the cells), and diffuse (>50%of the cells). Theintensity was graded as negative, weak, or strong.3Statistical analysisStatistics software of edition SPSS17.0was used for data analysis. Thenormal data was expressed as mean±SEM and non-normal data wasexpressed as percentiles. The data was assessed statistically using one-way analysis of variance (ANOVA) and nonparametric test. Statistical significancewas set at P <0.05.Results:1The average age were51.71±13.56years,53.2±17.29years,52.15±11.14years in fundic gland polyp group, gastric hyperplastic polyp group andthe control group respectively. The proportion of men and women of threegroups was5:8,9:16,3:7respectively. There was no significant difference ingender and age among three groups.2Fundic gland polyps were found0cases in gastric antrum,22cases ingastric body,28cases in gastric fundus; hyperplastic polyps were located ingastric antrum were23cases,3cases in gastric body and none of hyperplasticpolyps was found in fundus of stomach.3The expression of β-catenin protein in fundic gland polyp group waslower than that of control group, statistical comparison P=0.014<0.05, theresult was significant statistically; MUC6was lower than that of control group,statistical comparison P=0.015<0.05, the result was significant statistically.4The expression of β-catenin protein in hyperplastic polyp group waslower than that of control group, statistical comparison P=0.000<0.05, theconsequence was statistically significant; MUC6was lower than that ofcontrol group, statistical comparison P=0.000<0.05, the consequence wasstatistically significant.5The expression of β-catenin protein in fundic gland polyp group washigher than that of hyperplastic polyp group; statistical comparisonP=0.007<0.05, the consequence was statistically significant; MUC6washigher than that of control group, statistical comparison P=0.018<0.05, theconsequence was statistically significant.Summary:1The patents of fundic gland polyps, gastric hyperplastic polyps werealmost middle-aged people; fundic gland polyps were often found in thegastric fundus, body, while hyperplastic polyps were found mostly in thegastric antrum. 2The expression of β-catenin protein in fundic gland polyps andhyperplastic polyps was lower than that of control group, which showed thereduce of β-catenin protein maybe one of the mechanism of polyps’formation.3The expression of MUC6in fundic gland polyps and hyperplasticpolyps was lower than that of control group, the reduce of MUC6maybe theother mechanism of polyps’ formation.Conclusions:1The relationship between the bile acid and pH of gastric juice andfundic gland polyps and hyperplastic polyps’ formation and growth was notvery clear.2The decrease of β-catenin protein and MUC6in Fundic gland polypsand hyperplastic polyps maybe the mechanism of polyps’ formation. |
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