title: The histological and immunohistochemical aspects of bile reflux in patients with gastroesophageal reflux disease.
abstract: Introduction. The pathogenesis of GERD is strongly related with mixed acid and bile reflux. Benign and malignant esophageal and gastric lesions have been associated with synergetic activity between those parameters. Bile reflux causes reactive gastropathy evaluated with Bile Reflux Index (BRI). The aim was to investigate if the sequence: bile reflux-intestinal metaplasia-GERD-esophagitis, is associated with apoptotic/oncogenetic disturbances. Materials/Methods. Fifteen asymptomatic subjects and 53 GERD patients underwent gastroscopy with biopsies. The specimens examined histologically and immunohistochemically for p53, Ki-67, Bax, and Bcl-2. Results. Elevated BRI score detected in 47% (25/53) of patients with GERD and in 13% (2/15) of controls (P = 0.02). Severe esophageal lesions were significantly more common in BRI (+) patients (14/25) compared to BRI (-) ones (P = 0.0049). Immunohistochemical analysis did not show associations between BRI score and biomarker expression. Conclusions. Bile reflux gastropathy is associated with GERD severity, but not with oncogene expression or apoptotic discrepancies of the upper GI mucosa.
authors.affiliation: Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nakos
authors.forename: Georgios
authors.initials: G
authors.lastname: Kouklakis
authors.forename: Michail
authors.initials: M
authors.lastname: Pitiakoudis
authors.forename: Petros
authors.initials: P
authors.lastname: Zezos
authors.forename: Eleni
authors.initials: E
authors.lastname: Efraimidou
authors.forename: Alexandra
authors.initials: A
authors.lastname: Giatromanolaki
authors.forename: Alexandros
authors.initials: A
authors.lastname: Polychronidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Liratzopoulos
authors.forename: Efthimios
authors.initials: E
authors.lastname: Sivridis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Simopoulos