Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Carriage of Helicobacter Pylori in the human stomach is associated with increased risk of peptic ulcer
disease, distal gastric adenocarcinoma and gastric B-cell mucosa associated lymphoid tissue lymphoma.
OBJECTIVE:
To study the immunohistochemical expression of bcl-2, as apoptosis makers in the gastric mucosa of
patients infected with cagA Helicobacter Pylori demonstrated by insitu hybridization method.
PATIENTS MATERIALS AND METHODS:
Gastric antrum biopsies from 99 patients presented with dyspeptic symptoms (50 men, 49 women,
median age 40) were analysed for the presence of H. pylori, and were classified according to updated
Sydney system. Insitu hybridization technique was done to detect cagA H. pylori.
Immunohistochemical expression of bcl-2 using (Avidin- Biotin method) was performed on paraffin
embedded biopsy specimens.
RESULTS:
Forty four patients (44.44%) had H. pylori cagA positive starin. Atrophy of gastric mucosa was present
in 14 (14.14 %) patients. Intestinal metaplasia was present in 8 (8.08%) patients. The frequency of
atrophy and intestinal metaplasia were significantly higher in cagA H. pylori gastritis than non-cagA H.
pylori gastritis (p=0.023 and 0.041respectively). Bcl2 expression was not significantly higher in H.
pylori gastritis than non-H. pylori gastritis (p= 0.101). Bcl2 expression was significantly higher in the
presence of atrophy (p<0.001). Bcl2 expression was significantly higher in the presence of intestinal
metaplasia (p<0.001).
CONCLUSION:
The rate of apoptosis decreases when lesions (gastric atrophy and intestinal metaplasia) are present.