Expression And Clinical Significance Of P38MAPK?EMT In Gastroesophageal Reflux Disease

Objective:To investigate the expression of p38 MAPK,E-cadherin,Vimentin proteins in paracancerous tissues of esophageal adenocarcinoma,gastroesophageal reflux disease and esophageal adenocarcinoma tissues,and to analyze the expression of the above three indicators in gastroesophageal reflux disease and their relationship with clinical characteristics.Methods:42 cases of gastroesophageal reflux disease tissue(including 21 cases of reflux esophagitis and 21 cases of Barrett esophagus),9 cases of paracancerous tissue of esophageal adenocarcinoma,and 9 cases of esophageal adenocarcinoma were collected from Pathology Department of Zunyi Medical University.All the above cases have complete clinical data,including general clinical data,clinical symptoms and H.pylori infection.The expression levels of p38 MAPK,E-cadherin and Vimentin in paracancerous of esophageal,gastroesophageal reflux disease and esophageal adenocarcinoma tissues were detected through immunohistochemistry,as well as the positive rate in reflux esophagitis and Barrett esophagus.The staining intensity and the staining positive rate were used to determine the immunohistochemical results.The Chi-square test / Fisher exact probability method was used to analyze the expression of the above indicators and the relationship with the clinical characteristics.Spearman correlation was used to analyzes the correlation between the above indicators.Results:1.There were 42 patients with gastroesophageal reflux disease,the average age were 54.52 ± 15.13 years old,15 patients were female(35.7%),27 were male(64.3%),9 patients were smoking(21.4%),and 11 patients were drinking(26.2%),there were 16 cases(38.1%)of H.pylori infection.The symptoms were primarily heartburn or reflux in 25(59.5%)cases,abdominal distension or abdominal pain in 22(52.3%)cases,dysphagia or obstruction in 13(31.0%)cases,and chest pain in 3(7.1%)cases.2.p38 MAPK is expressed in paracancerous tissues of esophageal adenocarcinoma,gastroesophageal reflux disease and esophageal adenocarcinoma,with positive rates of 11.1%(1/9),59.5%(25/42),and 88.9%(8/9),respectively.Significant difference(P<0.05)can be found between the gastroesophageal reflux disease group and the paracancerous group,on the contrary,negligibly small difference is emerged compared with the adenocarcinoma group(P>0.05).E-cadherin was expressed in paracancerous tissues of esophageal adenocarcinoma,gastroesophageal reflux disease and esophageal adenocarcinoma,with positive rates of 88.9%(8/9),76.2%(32/42),and 22.2%(2/9),respectively.There was no significant difference between the gastroesophageal reflux disease group and the paracancerous group(P>0.05),and the difference was statistically significant compared with the adenocarcinoma group(P<0.05).Vimentin is expressed in paracancerous tissues of esophageal adenocarcinoma,gastroesophageal reflux disease and esophageal adenocarcinoma tissues,with positive rates of 11.1%(1/9),69.0%(29/42),and 88.9%(8/9),respectively.The difference between the esophageal reflux disease group and the paracancerous group was statistically significant(P < 0.05),and there was no significant difference compared with the adenocarcinoma group(P>0.05).3.The expressions of p38 MAPK,Vimentin in gastroesophageal reflux disease were not related to gender,age and H.pylori infection(P>0.05),however,they related to the GERD type(P<0.05).The expression of E-cadherin in gastroesophageal reflux disease was independent of sex,age,H.pylori infection and GERD type(P>0.05).Besides,there was no correlation between the above three indicators in gastroesophageal reflux disease(P>0.05).Conclusion:1.Gastroesophageal reflux disease occurs in middle-aged men and may be associated with smoking,alcohol consumption and H.pylori infection.Gastroesophageal reflux disease is mainly manifested by heartburn or reflux,and abdominal distension or abdominal pain is the secondary manifestation.2.In paracancerous tissues of esophageal adenocarcinoma,gastroesophageal reflux disease tissues,esophageal adenocarcinoma tissues,p38 MAPK and Vimentin are expressed in a gradually increasing trend,while E-cadherin is expressed in a gradually decreasing trend.Their abnormal expression may be involved in the pathogenesis of gastroesophageal reflux disease and esophageal adenocarcinoma.3.In reflux esophagitis,Barrett esophagus,the positive rate of p38 MAPK and Vimentin expression significantly increased,indicating that p38 MAPK and Vimentin were expressed differently in different types of gastroesophageal reflux disease.