Cell proliferation in the post-surgical stomach, dietary salt, and the effect of H pylori eradication.
OBJECTIVE
To study the epithelial kinetics of the post-surgical stomach with reference to dietary salt intake and H pylori.


METHODS
Endoscopic biopsies of the antrum/anastomosis and corpus were taken for histology and MIB-1 immunostaining. The labelling index (LI%) was determined in the three zones of the gastric glands (zone 1 = surface + gastric pit; zone 2 = isthmus; zone 3 = gland base) in patients with vagotomy and pyloroplasty (n = 12), gastroenterostomy + vagotomy (n = 4), partial gastrectomy (n = 3), and Billroth I operation (n = 3). Dietary salt was determined by urinary sodium/creatinine ratio. Twelve patients were H pylori positive (10 vagotomy and pyloroplasty; 2 partial gastrectomy) and had a repeat biopsy three months after antihelicobacter treatment (10 were H pylori negative after treatment).


RESULTS
There was no correlation between salt intake and antrum/anastomosis (r = -0.34; p = 0.2) or corpus (r = -0.16; p = 0.2) labelling indices. Gastric mucosal proliferation is increased in the antrum/ anastomosis compared to the corpus in H pylori positive (p = 0.014) but not H pylori negative subjects (p = 0.084). This may reflect the different types of post-surgical stomach in each group. Gastric mucosal proliferation is reduced in antrum/anastomosis (p = 0.002) and corpus (p = 0.016) following H pylori eradication.


CONCLUSIONS
Dietary salt does not influence gastric mucosal proliferation in the post-surgical stomach but H pylori may have a role in gastric stump carcinogenesis.
Willis
P
P
Department of Histopathology, Blackburn Royal Infirmary, UK.
Lynch
D A
DA
Prescott
R
R
Lamonby
S
S
D000328:Adult; D000368:Aged; D002455:Cell Division / Q000187:drug effects; D004847:Epithelial Cells / Q000187:drug effects / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D017673:Sodium Chloride, Dietary / Q000494:pharmacology*; D013270:Stomach / Q000382:microbiology / Q000601:surgery*
D017673:Sodium Chloride, Dietary