Expression of 8-hydroxydeoxyguanosine in the gastric remnant after distal gastrectomy.
OBJECTIVE
The correlation between remnant gastritis after distal gastrectomy for gastric cancer and expression of 8-hydroxydeoxyguanosine (8-OHdG) and inducible oxide synthase (iNOS) as a marker of oxidative DNA damage was investigated.


METHODS
Ninety-seven patients who had undergone curative distal gastrectomy for gastric cancer were studied. Reconstructive procedures included Billroth I, Billroth II, and Roux-Y reconstruction in 42, 27, and 28 patients, respectively. Histologic and immunohistochemical analyses were performed on biopsy specimens of the gastric mucosa obtained endoscopically within 2 weeks before and 12 weeks after surgery. The grades of remnant gastritis were evaluated according to the updated Sydney System. 8-OHdG and iNOS expression levels, detected immunohistochemically, were graded.


RESULTS
Neutrophil infiltration correlated with expression of 8-OHdG (p = 0.02). Expression of iNOS also correlated with 8-OHdG (p = 0.02). The ratio of postoperative to preoperative infiltration of neutrophils was less in patients who underwent Roux-Y reconstruction than in others (p = 0.04).


CONCLUSIONS
These results suggest that remnant gastritis possibly causes DNA damage. Excess production of reactive oxygen species correlates with carcinogenic DNA changes. Roux-Y reconstruction may reduce carcinogenesis in the gastric remnant.
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
Takemura
Masashi
M
Lee
Shigeru
S
Morimura
Keiichirou
K
Nishikawa
Takayuki
T
Iwasaki
Hiroshi
H
Fukushima
Shoji
S
Suehiro
Shigefumi
S
D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000096:biosynthesis; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000378:metabolism; D018530:Gastric Stump; D006801:Humans; D052247:Nitric Oxide Synthase Type II / Q000096:biosynthesis; D013274:Stomach Neoplasms / Q000601:surgery
D000080242:8-Hydroxy-2'-Deoxyguanosine; D052247:Nitric Oxide Synthase Type II; D003849:Deoxyguanosine