Effect of H. pylori on COX-2 expression in gastric remnant after distal gastrectomy.
OBJECTIVE
Helicobacter pylori infection is known to induce gastritis, oxidative stress, and cyclooxygenase (COX)-2 expression in the gastric mucosa. However, the effect of H. pylori infection on remnant gastritis has not been studied. We investigated whether the severity of remnant gastritis and COX-2 expression were affected by H. pylori infection after distal gastrectomy.


METHODS
The study included 97 patients with gastric cancer who underwent curative distal gastrectomy with lymphadenectomy in our department between May 1999 and April 2001. All patients underwent endoscopic examination 2 weeks before and 12 weeks after surgery. The presence of H. pylori infection was determined by urease activity, hematoxylin-eosin staining, and immunochemical staining. Histologic remnant gastritis was graded based on the degree of neutrophil infiltration using the updated Sydney System. COX-2 expression was estimated immunohistochemically.


RESULTS
Both the degree of neutrophil infiltration and the level of COX-2 expression were significantly higher in patients with than without H. pylori (p<0.05). There was a significant correlation between the degree of neutrophil infiltration and the degree of COX-2 expression (p<0.001).


CONCLUSIONS
H. pylori eradication may become a treatment for preventing both remnant gastritis as well as remnant gastric carcinoma after distal gastrectomy.
Fukuhara
Kenichiro
K
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. fuku@eva.hi-ho.ne.jp
Osugi
Harushi
H
Takada
Nobuyasu
N
Takemura
Masashi
M
Lee
Shigeru
S
Morimura
Keiichiro
K
Taguchi
Shinichi
S
Kaneko
Masahiro
M
Tanaka
Yoshinori
Y
Fujiwara
Yushi
Y
Nishizawa
Satoshi
S
Fukushima
Shoji
S
Kinoshita
Hiroaki
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D051546:Cyclooxygenase 2; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D018530:Gastric Stump / Q000473:pathology*; D005756:Gastritis / Q000473:pathology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D007124:Immunoenzyme Techniques; D007527:Isoenzymes / Q000032:analysis; D008197:Lymph Node Excision; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D020556:Neutrophil Infiltration; D011451:Prostaglandin-Endoperoxide Synthases / Q000032:analysis; D013274:Stomach Neoplasms / Q000601:surgery*
D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases