Pathological and immunohistochemical analysis of gastric mucosa after one anastomosis gastric bypass surgery

IF 0.9 Q4 ORTHOPEDICS Asian Journal of Endoscopic Surgery Pub Date : 2024-05-28 DOI:10.1111/ases.13324

Xiaoguang Qin, Zhongqi Mao, Wei-Jei Lee, Min Zhang, Guoqiang Wu, Xiaoqing Zhou

{"title":"Pathological and immunohistochemical analysis of gastric mucosa after one anastomosis gastric bypass surgery","authors":"Xiaoguang Qin, Zhongqi Mao, Wei-Jei Lee, Min Zhang, Guoqiang Wu, Xiaoqing Zhou","doi":"10.1111/ases.13324","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>One anastomosis gastric bypass (OAGB) is now the third most common bariatric surgery worldwide. This procedure is garnering increasing attention, but its complication of bile reflux and the associated risk of gastric carcinogenesis remains controversial.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>The study aims to assess the impact of bile reflux on the gastric mucosa by comparing pathological and immunohistochemical results of gastric mucosa before and 2 years after OAGB surgery.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective study analyzed gastric lesions observed in gastroscopy before and after OAGB surgery. Pathological examinations were conducted on mucosal samples from proximal, middle and distal part of stomach, with a particular focus on the expression of Ki-67, P53, and CDX2 in immunohistochemistry. Ki-67 indicates cellular proliferation, P53 is a tumor suppressor protein, and CDX2 is a marker for intestinal differentiation.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 16 patients completed the follow-up. Regarding gastritis, presurgery nonerosive gastritis was found in two cases (12.5%), and postsurgery in six cases (37.5%). Erosive gastritis increased from one case (6.2%) presurgery to three cases (18.7%) postsurgery, totaling an increase from three to nine cases (<i>p</i> = .028). Bile reflux in the stomach increased from one case (6.2%) presurgery to three cases (18.7%) postsurgery. Most lesions in the proximal, middle, and distal part of stomach were relatively mild, with normal tissue states being predominant. Mild inflammation was found in all three areas, whereas moderate inflammation, intestinal metaplasia, and glandular atrophy were less common. No cases of severe inflammation were noted. The expression of gastric biomarkers CDX-2, Ki67, and P53 showed no significant statistical variation in different areas.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Bile reflux does occur after OAGB, but its incidence is not high. Based on the immunohistochemical and pathological results of the gastric mucosa 2 years post-OAGB, there seems to be no significant causal relationship between OAGB and oncogenic inflammation around the gastric tube.</p>\n </section>\n </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9000,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13324","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Journal of Endoscopic Surgery","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ases.13324","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

One anastomosis gastric bypass (OAGB) is now the third most common bariatric surgery worldwide. This procedure is garnering increasing attention, but its complication of bile reflux and the associated risk of gastric carcinogenesis remains controversial.

Objective

The study aims to assess the impact of bile reflux on the gastric mucosa by comparing pathological and immunohistochemical results of gastric mucosa before and 2 years after OAGB surgery.

Methods

This retrospective study analyzed gastric lesions observed in gastroscopy before and after OAGB surgery. Pathological examinations were conducted on mucosal samples from proximal, middle and distal part of stomach, with a particular focus on the expression of Ki-67, P53, and CDX2 in immunohistochemistry. Ki-67 indicates cellular proliferation, P53 is a tumor suppressor protein, and CDX2 is a marker for intestinal differentiation.

Results

A total of 16 patients completed the follow-up. Regarding gastritis, presurgery nonerosive gastritis was found in two cases (12.5%), and postsurgery in six cases (37.5%). Erosive gastritis increased from one case (6.2%) presurgery to three cases (18.7%) postsurgery, totaling an increase from three to nine cases (p = .028). Bile reflux in the stomach increased from one case (6.2%) presurgery to three cases (18.7%) postsurgery. Most lesions in the proximal, middle, and distal part of stomach were relatively mild, with normal tissue states being predominant. Mild inflammation was found in all three areas, whereas moderate inflammation, intestinal metaplasia, and glandular atrophy were less common. No cases of severe inflammation were noted. The expression of gastric biomarkers CDX-2, Ki67, and P53 showed no significant statistical variation in different areas.

Conclusion

Bile reflux does occur after OAGB, but its incidence is not high. Based on the immunohistochemical and pathological results of the gastric mucosa 2 years post-OAGB, there seems to be no significant causal relationship between OAGB and oncogenic inflammation around the gastric tube.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

单吻合胃旁路手术后胃黏膜的病理和免疫组化分析。

背景：单吻合胃旁路术（OAGB）是目前全球第三大最常见的减肥手术。这种手术正受到越来越多的关注，但其并发症胆汁反流及相关的胃癌风险仍存在争议：本研究旨在通过比较 OAGB 术前和术后 2 年胃黏膜的病理和免疫组化结果，评估胆汁反流对胃黏膜的影响：这项回顾性研究分析了 OAGB 手术前后胃镜观察到的胃部病变。病理检查取材于胃的近端、中部和远端，重点观察免疫组化中 Ki-67、P53 和 CDX2 的表达。Ki-67 表示细胞增殖，P53 是肿瘤抑制蛋白，CDX2 是肠道分化的标志物：共有 16 名患者完成了随访。关于胃炎，手术前发现非侵蚀性胃炎的有 2 例（12.5%），手术后发现侵蚀性胃炎的有 6 例（37.5%）。腐蚀性胃炎从手术前的 1 例（6.2%）增加到手术后的 3 例（18.7%），总计从 3 例增加到 9 例（p = 0.028）。胃内胆汁反流从手术前的一例（6.2%）增加到手术后的三例（18.7%）。胃的近端、中部和远端大部分病变相对较轻，以正常组织状态为主。这三个部位都有轻度炎症，而中度炎症、肠化生和腺体萎缩则较少见。没有发现重度炎症病例。胃生物标志物 CDX-2、Ki67 和 P53 的表达在不同地区没有明显的统计学差异：结论：OAGB术后确实会出现胆汁反流，但发生率并不高。根据 OAGB 术后 2 年胃粘膜的免疫组化和病理结果，OAGB 与胃管周围的肿瘤性炎症之间似乎没有明显的因果关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊