Production of secretory component and pathogenesis of gastric cancer in Helicobacter pylori-infected stomach.
The purpose of this study was to examine the production of secretory component (SC) and immunoglobulin A (IgA) in the gastric mucosa with Helicobacter pylori infection and to investigate the influence of immunological reactions on various phases of infection (gastritis, intestinal metaplasia, gastric cancer). Production of SC and IgA was assessed by immunohistochemical staining in (1) endoscopic biopsy samples of H. pylori-eradicated cases (n = 25), and (2) surgically resected stomach tissues of H. pylori-positive gastric cancer cases, intestinal type (IGC, n = 25) and diffuse type (DGC, n = 25). Before eradication therapy, all samples showed positive staining of SC and IgA in epithelial cells, and IgA was also positive in plasma cells in the mucosal layer. H. pylori bacteria were positively stained for SC and IgA. After treatment, the degree of SC and IgA staining in epithelial cells was reduced with successful eradication; but with intestinal metaplasia, SC staining was positive regardless of the results of treatment. In nonmetaplastic mucosa, SC-positive cells were increased in the glandular neck zone to the surface mucosal layer; and the intensity of SC staining was increased in proportion to the degree of mucosal inflammation and IgA-positive cell aggregation. In intestinal metaplasia, SC was positive irrespective of the degree of inflammation. Most cancer foci also showed positive staining of SC, irrespective of histological type. Production of SC and IgA was thought to be a specific reaction against H. pylori infection, occurring from the early to the late stages and not limited to intestinal metaplasia. It was suggested that immunological reactions against H. pylori infection might generally be involved with the pathogenesis of intestinal metaplasia and both histological types of gastric cancer (IGC and DGC).
Handa
Y
Y
Fourth Department of Internal Medicine, Tokyo Medical University, Japan.
Saitoh
T
T
Kawaguchi
M
M
Misaka
R
R
Tsurui
M
M
Ohno
H
H
Morita
S
S
Sanji
T
T
Tani
Y
Y
Sakai
Y
Y
Umezawa
H
H
D005753:Gastric Mucosa / Q000378:metabolism*; D016481:Helicobacter Infections / Q000150:complications / Q000276:immunology*; D016480:Helicobacter pylori; D006801:Humans; D007070:Immunoglobulin A / Q000302:isolation & purification / Q000378:metabolism*; D007150:Immunohistochemistry; D012635:Secretory Component / Q000096:biosynthesis* / Q000302:isolation & purification; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology
D007070:Immunoglobulin A; D012635:Secretory Component