ABSTRACT
Ectopic gastric mucosa (EGM) is considered to be a congenital condition. Rare cases of adenocarcinoma have been described. There are no data justifying regular biopsies or follow-up. Cyclooxygenase-2 (COX-2) is a protein involved in gastrointestinal tumor development by inhibiting apoptosis and regulating angiogenesis. The aim of this prospective study was to evaluate COX-2 expression in EGM and compare it with normal tissue and Barrett's esophagus. We evaluated 1327 patients. Biopsies were taken from the inlet patch for histological evaluation and from the gastric antrum to assess Helicobacter pylori infection. Biopsies taken from normal esophageal, gastric antrum and body mucosa and Barrett's esophagus were retrieved from a tissue bank. EGM biopsies were evaluated with respect to type of epithelium, presence of H. pylori, and inflammation. COX-2 was detected by immunohistochemistry using the avidin-biotin complex. EGM islets were found in 14 patients (1.1 percent). Histological examination revealed fundic type epithelium in 58.3 percent of cases, H. pylori was present in 50 percent and chronic inflammation in 66.7 percent. Expression of COX-2 was negative in normal distal esophagus, normal gastric antrum and normal gastric body specimens (10 each). In contrast, EGM presented over-expression of COX-2 in 41.7 percent of cases and Barrett's esophagus in 90 percent of cases (P = 0.04 and 0.03, respectively). COX-2 immunoexpression in EGM was not related to gender, age, epithelium type, presence of inflammation or intestinal metaplasia, H. pylori infection, or any endoscopic finding. Our results demonstrate up-regulation of COX-2 in EGM, suggesting a possible malignant potential of this so-called harmless mucosa.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Choristoma/enzymology , /metabolism , Esophageal Diseases/enzymology , Gastric Mucosa/enzymology , Pyloric Antrum/enzymology , Biopsy , Barrett Esophagus/enzymology , Barrett Esophagus/pathology , Choristoma/pathology , Esophageal Diseases/pathology , Gastric Mucosa/pathology , Helicobacter pylori/isolation & purification , Prospective Studies , Pyloric Antrum/microbiology , Pyloric Antrum/pathologyABSTRACT
Ulcerative colitis (UC) is a disease of the colon and rectum characterized by a nonspecific chronic inflammation mediated by the concerted response of cellular and humoral events. Prostaglandins are synthesized by cyclooxygenase (COX)-1 and -2 and exhibit both pro- and anti-inflammatory activity. To evaluate COX-1 and COX-2 immunoexpression in 42 cases of UC and to correlate it with clinicopathological parameters, COX-1 and COX-2 expression was investigated by the immunohistochemistry method. Only patients with all pertinent clinical and evolutive data as well as with adequate biopsy material were included in the study. Fifteen samples of colorectal adenocarcinoma and 14 of large bowel with no histological changes were used for positive and negative controls, respectively. UC patients showed COX-1 immunoreactivity in epithelial cells in 29 percent of the cases and in inflammatory cells in 43 percent. COX-2 positivity in epithelial and inflammatory cells was found in 69 percent of the samples. The comparison between UC and the control groups revealed that the UC group had significantly more positive cases for COX-1 and COX-2 in inflammatory cells. Immunohistochemistry allowed the identification of COX-1 and COX-2 expression in epithelial and inflammatory cells in UC biopsies. No significant difference between COX-1 and COX-2 immunoreactivity in epithelial and inflammatory cells was observed regarding the clinicopathological parameters. COX-2 presented low expression in normal colon and high expression in colorectal adenocarcinoma. COX-2 might play a role in the pathophysiologic processes of inflammatory bowel disease and the development of neoplasia. Treatment with selective COX-2 inhibitors might be an additional option for therapy.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Colitis, Ulcerative/enzymology , Colorectal Neoplasms/enzymology , Cyclooxygenase 1/metabolism , /metabolism , Colitis, Ulcerative/pathology , Colorectal Neoplasms/pathology , Follow-Up Studies , Immunohistochemistry , Severity of Illness IndexABSTRACT
O objetivo deste trabalho foi a determinaçäo das concentraçöes dos receptores de estrógeno (ER) e progesterona (PR) em exocérvix humana. Ensaiamos ER e PR em vários "pools" de 25 fragmentos de exocérvix de mulheres normais obtidos por curetagem e em endométrios obtidos de pacientes submetidas à histerectomia por condiçöes näo malignas. Os "pools" de fragmentos de exocérvix foram separados em quatro tipos: 1) os referentes às mulheres na fase luteal; 2) na fase proliferativa do ciclo menstrual; 3) em uso de anticoncepcionais e 4) na menopausa. As dosagens dos receptores de estrógeno e progesterona foram feitas pelo método de carväo-dextrana. As concentraçöes de ER e PR encontradas na exocérvix foram respectivamente 15% e 3,6% das encontradas no endométrio, mas com constantes de afinidade semelhantes. Näo detectamos flutuaçöes na concentraçäo de ER e PR em exocérvix durante a fase proliferativa e luteal. Nas amostras de exocérvix de usuárias de anticoncepcionais, apenas o nível de PR foi estatisticamente menor quando comparado aos níveis obtidos na fase luteal e proliferativa. Os valores de ER e PR em exocérvix de mulheres pós-menopáusicas säo estatisticamente maiores do que os encontrados em mulheres pré-menopáusicas. Näo há diferenças em relaçäo ao tempo de menopausa. O efeito de estrógeno e progesterona na porçäo cervical é aparentemente limitado pela baixa concentraçäo dos seus respectivos receptores