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Characterization of the Gastric Cardia in Volunteers from the General Population

Type of Mucosa, Helicobacter pylori Infection, Inflammation, Mucosal Proliferative Activity, p53 and p21 Expression, and Relations to Gastritis

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Abstract

The aim of this research was to characterize the mucosa of the gastric cardia in relation to infection with Helicobacter pylori and the occurrence of chronic gastritis in other parts of the stomach in a sample of the general population. In this study, 80 adult volunteers underwent esophagogastroscopy with biopsies from the gastric cardia, corpus, and antrum. Gastritis was classified according to the Sydney system. Chronic gastritis (cardia excepted) was diagnosed in 35 subjects, 30 with H. pylori infection. Epithelial proliferative activity (Ki-67), p53- and p21 expression were examined quantitatively with cell counting after immunohistochemical stainings. Esophagitis was diagnosed macroscopically. Fourty eight subjects had cardia-type and 32 corpus-type mucosa in the anatomical cardia. The prevalence of esophagitis (nine cases) did not differ between these groups. Carditis was more prevalent among subjects with cardia-type mucosa (73 vs. 28%, P < 0.0001). H. pylori was present in 48% of those with cardia-type and 25% of those with corpus-type mucosa (P = 0.06). Of the 44 subjects with carditis, 31 had H. pylori in this location. The group with H. pylori infection had significantly higher mucosal proliferative activity when compared to uninfected subjects. Among the subjects with H. pylori-associated carditis, more p53-positive epithelial cells were detected compared to both the non-infected group (P = 0.0004) and to subjects with non-H. pylori-associated carditis (P = 0.03). In subjects with cardia-type mucosa, and both carditis and gastritis, the degree of chronic inflammation was higher in the cardia compared to the corpus and antrum and the p53 expression was significantly higher in the cardia compared to the corpus, but similar to that in the antrum. The proliferative activity was significantly higher in the antrum compared to the cardia and corpus, respectively. In conclusion, H. pylori infection, carditis, and increased p53 expression are more common in subjects with cardia- than corpus-type mucosa in the gastric cardia. Carditis is mainly related to H. pylori infection. There are some differences regarding inflammation, proliferative activity, and p53 expression between the cardia and other regions of the stomach, yet the significance of these differences remains to be clarified.

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Acknowledgments

This study was supported by grants from the Research Council in the South East of Sweden (FORSS), the Foundation for Clinical Cancer Research in Jönköping, the Swedish Cancer Society and the research committee of Örebro County Council and Örebro Medical Research Foundation. We sincerely thank Eva Möller and Ingrid Svensson, Department of Pathology, Ryhov Hospital, Jönköping, Sweden, for enduring and skilful laboratory assistance. The statistical advice provided by Olle Eriksson, L.SSc, Consultant statistician, Department of Mathematics, University of Linköping, Sweden, is greatly appreciated.

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Authors and Affiliations

  1. Pathology Research Department, Ryhov Hospital, Jonkoping, Sweden

    Fredrik Petersson

  2. Department of Pathology, Karolinska University Hospital, 17176, Stockholm, Sweden

    Fredrik Petersson

  3. Department of Pathology, Medical Centre Hospital, Orebro, Sweden

    Lennart E. Franzén

  4. Department of Surgery, University Hospital of Linköping, Linkoping, Sweden

    Kurt Borch

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  1. Fredrik Petersson
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Correspondence to Fredrik Petersson.

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Petersson, F., Franzén, L.E. & Borch, K. Characterization of the Gastric Cardia in Volunteers from the General Population. Dig Dis Sci 55, 46–53 (2010). https://doi.org/10.1007/s10620-008-0705-0

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  • DOI: https://doi.org/10.1007/s10620-008-0705-0

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