Bcl-2 expression in CagA strain H. pylori gastritis [immunohistochemical and insitu hybridization study]

ABSTRACT

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. 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. 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. 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 0.041 respectively]. 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]. The rate of apoptosis decreases when lesions [gastric atrophy and intestinal metaplasia] are present