The present study was carried out to assess the predictive value and expression of the proliferative activity of Ki-67 and the expression of p53 protein in Helicobacter pylori associated chronic gastritis. This study comprised archival blocks from 20 dyspeptic patients who at National Hepatology and Tropical Medicine Research Institute underwent a diagnostic oesophago-gastroduodenoscopy with multiple gastric antral endoscopic biopsies for histological examination. The blocks were cut at 5 nM thicknesses, stained by hematoxylin and eosin to score the inflammatory grade and subjected to Giemsa stain to assess H. pylori infection, and then immune-histochemical method was done to determine protein P53 and Ki-67. The obtained results indicated that there was no significant association between the expression of Ki67 and P53 in the studied cases. There was no significant association between Ki67 and P53 in the presence of intestinal atrophy, intestinal metaplasia, intestinal activity and intestinal inflammation. While, there was significant association between Ki67 and P53 in intestinal dysplasia, P = 0.015, 0.025, respectively. It could be concluded that the significant association of the proliferative marker Ki-67 and apoptotic marker p53 protein with intestinal dysplasia may be one of the main predictive values in the development of gastric carcinoma in patients with gastritis secondary to H. pylori infection.
Objective of this study was to asses the sensitivity, specificity and the predictive value of a 'gastropanel' blood test, including serum pepsinogen I (S-PGI) and amidated gastrin-17 (S-G-17) in the diagnosis of atrophic gastritis most probably due to helicobacter pylori (Hp) and to compare the results of serology with the endoscopic/histopathologic findings as a gold standard diagnostic tool. This study comprised 86 dyspeptic outpatients who underwent a diagnostic gastroscopy with multiple biopsies from the antrum and corpus for histopathologic examination. Histopathologically, the series of cases included 46 patients diagnosed as having atrophic gastritis. Twenty five had an antral atrophy, 6 had corpus atrophy and 15 patients had an atrophic gastritis in both the antrum and corpus (multifocal atrophic gastritis) MAG. The remaining 40 cases were considered as controls, 32 had a non-atrophic gastritis (NAG) and both the antrum and corpus were normal and healthy in 8 subjects. The fasting levels of S-PGI and antibodies to Hp IgG-antibodies (S-HpAb) and postprandial amidated S-G-17 (S-G-17prand) were measured 20 min after a protein-rich drink and were determined using enzyme immunoassay (EIA) methods. The serologic and morphologic results were compared with estimating the sensitivity, specificity, positive and negative predictive (PPV and NPV) and accuracy values of the tests (S-G-17 and S-PGI). Mean values of both S-G-17prand and S-PGI decreased with increasing grade of antral and corpus atrophy, respectively. A low S-PGI (<25 µg L-1) was found in 4 of 6 patients with corpus atrophy (66.70%) and in 5 of 32 (15.62%) patients with NAG in the biopsy specimens. A low S-G-17prand (<5 pmol L-1) was found in 13 patients with Hp-associated antral atrophy and in 5 of 32 (15.62%) patients with NAG. The diagnosis of gastritis obtained with the blood test panel is in good agreement with the endoscopic and biopsy findings: 92% of the patients went into same gastritis categories with both the panel and endoscopic/histopathologic findings. The sensitivity, specificity, PPV, NPV and accuracy values of the blood test panel (S-G-17prand and S-PGI) in delineation of patients with atrophic gastritis (either in the antrum or the corpus, or both) versus NAG and normal stomach were 87.5, 82.60, 81.40, 88.40 and 85% respectively. Low levels of S-G-17prand and S-PGI are conceivable biomarkers of atrophic gastritis. The serologic method gave a reasonable sensitivity, specificity, PPV, NPV and accuracy values in the diagnosis of atrophic gastritis. So, it may be offered as the screening tool for atrophic gastritis
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