title: Antral atrophy, intestinal metaplasia, and preneoplastic markers in Mexican children with Helicobacter pylori-positive and Helicobacter pylori-negative gastritis.
abstract: Chronic inflammation and infection are major risk factors for gastric carcinogenesis in adults. As chronic gastritis is common in Mexican children, diagnosis of Helicobacter pylori and other causes of gastritis are critical for the identification of children who would benefit from closer surveillance. Antral biopsies from 82 Mexican children (mean age, 8.3 ± 4.8 years) with chronic gastritis (36 H pylori+, 46 H pylori-) were examined for gastritis activity, atrophy, intestinal metaplasia (IM), and immunohistochemical expression of gastric carcinogenesis biomarkers caudal type homeobox 2 (CDX2), ephrin type-B receptor 4 (EphB4), matrix metalloproteinase 3 (MMP3), macrophage migration inhibitory factor (MIF), p53, β-catenin, and E-cadherin. Atrophy was diagnosed in 7 (9%) of 82, and IM, in 5 (6%) of 82 by routine histology, whereas 6 additional children (7%) (3 H pylori+) exhibited aberrant CDX2 expression without IM. Significant positive correlations were seen between EphB4, MMP3, and MIF (P<.0001). Atrophy and follicular pathology were more frequent in H pylori+ biopsies (P<.0001), whereas IM and CDX2 expression showed no significant correlation with H pylori status. Antral biopsies demonstrating atrophy, IM, and/or aberrant CDX2 expression were seen in 21.95% (18/82) of the children, potentially identifying those who would benefit from closer surveillance and preventive dietary strategies. Biomarkers CDX2, EphB4, MMP3, and MIF may be useful in the workup of pediatric gastritis.
authors.affiliation: Davidson Honors College, University of Montana, Missoula, MT 59812.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Villarreal-Calderon
authors.affiliation: Department of Pathology, Clinical and Translational Research Core Lab, Medical College of Wisconsin, Milwaukee, WI 53226.
authors.forename: Arturo
authors.initials: A
authors.lastname: Luévano-González
authors.affiliation: Pathology Department, Hospital Central Militar, Mexico City, Mexico.
authors.forename: Mariana
authors.initials: M
authors.lastname: Aragón-Flores
authors.affiliation: Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27599.
authors.forename: Hongtu
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27599.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI 53226.
authors.forename: Qun
authors.initials: Q
authors.lastname: Xiang
authors.affiliation: Department of Pathology, Clinical and Translational Research Core Lab, Medical College of Wisconsin, Milwaukee, WI 53226.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Yan
authors.affiliation: Department of Pathology, Clinical and Translational Research Core Lab, Medical College of Wisconsin, Milwaukee, WI 53226.
authors.forename: Kathryn Anne
authors.initials: KA
authors.lastname: Stoll
authors.affiliation: Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908.
authors.forename: Janet V
authors.initials: JV
authors.lastname: Cross
authors.affiliation: Department of Pathology, Clinical and Translational Research Core Lab, Medical College of Wisconsin, Milwaukee, WI 53226.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Iczkowski
authors.affiliation: Department of Pathology, Clinical and Translational Research Core Lab, Medical College of Wisconsin, Milwaukee, WI 53226. Electronic address: amackinnon@mcw.edu.
authors.forename: Alexander Craig
authors.initials: AC
authors.lastname: Mackinnon
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D016481:Helicobacter Infections / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011159:Population Surveillance; D011230:Precancerous Conditions / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D011706:Pyloric Antrum / Q000378:metabolism / Q000473:pathology*
chemical_list: D015415:Biomarkers
keywords: Antral gastritis; Biomarkers; Child; Helicobacter pylori; Mexican; Surveillance