Combined Use of Helicobacter pylori Genotyping and CDX2 Expression as a Predictor of Malignant Potential in Gastric Intestinal Metaplasia.

IF 1.1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY Annals of clinical and laboratory science Pub Date : 2024-01-01

Mengyuan Zhang, Zhong Zhang, Lanlan Jiao, Li Liang, Wei Bo, Min Zhang, Xiaobo Li, Xingwei Fu, Xuguang Wang

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Abstract

Objective: Gastrointestinal metaplasia (GIM) has a close relationship with gastric cancer (GC), but it is unclear how to judge which GIM could develop into GC. This study aimed to assess the role of CDX2 and its association with Helicobacter pylori (H.pylori) genotypes in GIM.

Methods: CagA and vacA genes were identified via PCR in 466 H. pylori-positive gastric tissues, including gastritis (n=104), GIM diagnosed endoscopically (GIM-1; n=82), gastric cancer (GC; n=173), and paired adjacent GIM tumors resected surgically (GIM-2; n=107). GIM was subclassified per the HID- AB pH2.5-PAS as follows: type I (n=23), type II (n=43), and type III (n=16) in GIM-1; type I (n=8), type II (n=40), and type III (n=59) in GIM-2. CDX2 expression was evaluated immunohistochemically.

Results: In GIM-1, the infection rate of vacAm2 (55.8%) and vacAs1m2 (53.5%) was higher in subtype II than in others (P<0.05), while that of vacAm1 (49.2%) and vacAs1m1 (33.9%) was higher in subtype III than in others. The cagA⁺ rate was higher in subtypes I (75.0%) and III (64.4%) than in subtype II (40.0%; P<0.05) respectively. CDX2 was upregulated in subtype I than in subtypes II and III in GIM-1 and GIM-2. In GIM-2 and GC, CDX2 was downregulated in vacAm1, vacAs1m1, and cagA⁺ (P<0.05). The predominant genotype was vacAs1m2 in subtype II of GIM-1, CDX2 expression remaining unaltered; however, the predominant genotype was cagA⁺ vacAs1m1 in subtypes II and III of GIM-2, negatively correlated with CDX2 expression.

Conclusion: These GIM subtypes (cagA⁺ vacAs1m1 H. pylori-positive GIM with negative CDX2 expression) resemble GC and should be evaluated similar to cancerous GIM.

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联合使用幽门螺杆菌基因分型和 CDX2 表达预测胃肠道增生的恶性潜能

目的：胃肠化生（GIM）与胃癌（GC）关系密切，但目前尚不清楚如何判断哪些GIM可能发展为GC。本研究旨在评估 CDX2 在 GIM 中的作用及其与幽门螺旋杆菌（H.pylori）基因型的关联：方法：通过 PCR 鉴定 466 例幽门螺杆菌阳性胃组织中的 CagA 和 vacA 基因，包括胃炎（104 例）、经内镜诊断的 GIM（GIM-1；82 例）、胃癌（GC；173 例）和经手术切除的成对相邻 GIM 肿瘤（GIM-2；107 例）。根据 HID- AB pH2.5-PAS 对 GIM 进行了以下亚分类：GIM-1 为 I 型（n=23）、II 型（n=43）和 III 型（n=16）；GIM-2 为 I 型（n=8）、II 型（n=40）和 III 型（n=59）。对 CDX2 的表达进行了免疫组化评估：结果：在 GIM-1 中，亚型 II 中 vacAm2（55.8%）和 vacAs1m2（53.5%）的感染率高于其他亚型（亚型 III 中 PvacAm1（49.2%）和 vacAs1m1（33.9%）的感染率高于其他亚型）。在 GIM-1 和 GIM-2 中，亚型 I（75.0%）和 III（64.4%）的 cagA+率高于亚型 II（40.0%）；亚型 I 中 PCDX2 的上调率高于亚型 II 和 III。在 GIM-2 和 GC 中，CDX2 在 GIM-1 亚型 II 中的 vacAm1、vacAs1m1 和 cagA+（PvacAs1m2）中下调，CDX2 的表达保持不变；但在 GIM-2 亚型 II 和 III 中，主要基因型为 cagA+ vacAs1m1，与 CDX2 的表达呈负相关：这些 GIM 亚型（cagA+ vacAs1m1 幽门螺杆菌阳性、CDX2 表达阴性的 GIM）与 GC 相似，应与癌症 GIM 一样进行评估。

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来源期刊

Annals of clinical and laboratory science 医学-医学实验技术

CiteScore

1.60

自引率

0.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： The Annals of Clinical & Laboratory Science welcomes manuscripts that report research in clinical science, including pathology, clinical chemistry, biotechnology, molecular biology, cytogenetics, microbiology, immunology, hematology, transfusion medicine, organ and tissue transplantation, therapeutics, toxicology, and clinical informatics.