Relevance of high virulence Helicobacter pylori strains and futility of CDX2 expression for predicting intestinal metaplasia after eradication of infection

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Barros R (Author) FMUP; peleteiro, b (Author) FMUP; Raquel Almeida (Author) FMUP; Figueiredo C (Author) FMUP; Barros H (Author) FMUP; David L (Author) FMUP; Lunet N (Author) FMUP

Journal

Title: Scandinavian Journal of Gastroenterology

Vol. 45

Pages: 828-834

ISSN: 0036-5521

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 14 Citations

Scopus - 14 Citations

Pubmed / Medline

Other information

Authenticus ID: P-003-4MG

DOI: 10.3109/00365521003770269

Abstract (EN): Objective. Different Helicobacter pylori genotypes are associated with distinct inflammatory responses and consequent development of pre-neoplastic lesions, namely intestinal metaplasia (IM), which is dependent on the expression of CDX2. We aimed to evaluate IM progression/regression in the context of H. pylori eradication, bringing into play the effect of the virulence of infecting H. pylori strains and the hypothesis that CDX2 expression might be a marker for later development of IM. Material and methods. Sixty-five male volunteers were evaluated by endoscopy before H. pylori eradication and after a median six-year follow-up. Histological diagnosis was performed at baseline and follow-up, and baseline H. pylori genotypes and CDX2 expression in non-metaplastic foci were also assessed. Results. Fifty-one individuals remained free from infection at follow-up. Six out of 27 who had no metaplastic lesions at baseline developed IM. CDX2 nuclear expression was observed in 15 of the 21 cases (71.4%) showing no progression to IM, and in three out of six cases (50%) with progression to IM (p = 0.367). Six of the 24 cases with IM at baseline showed regression to less severe outcomes, which was less frequent in those infected with high-virulence strains (7.7% vs. 50%, p = 0.047). In the latter there is a significant persistence of lymphoid follicles. Conclusions. Our results support that under infection with high virulence H. pylori strains, IM is a point of difficult return in the gastric carcinogenic pathway. The appearance of CDX-expressing cells in non-metaplastic foci was not associated with the development of IM during the six-year follow-up.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7