Antral atrophy, intestinal metaplasia, and preneoplastic markers in Mexican children with Helicobacter pylori–positive and Helicobacter pylori–negative gastritis

Abstract

Chronic inflammation and infection are major risk factors for gastric carcinogenesis in adults. As chronic gastritis is common in Mexican children, diagnosis of Helicobacter pylori and other causes of gastritis are critical for the identification of children who would benefit from closer surveillance. Antral biopsies from 82 Mexican children (mean age 8.3±4.8y) with chronic gastritis (36 H. pylori +, 46 H. pylori -) were examined for gastritis activity, atrophy, intestinal metaplasia, and immunohistochemical expression of gastric carcinogenesis biomarkers CDX2, ephrin type-B receptor 4, matrix metalloproteinase 3 (MMP3), macrophage migration inhibitory factor (MIF), p53, β-catenin, and E-cadherin. Atrophy was diagnosed in 7/82 (9%) and intestinal metaplasia in 5/82 (6%) by routine histology, while 6 (7%) additional children (3 H. pylori +) exhibited aberrant CDX2 expression without intestinal metaplasia. Significant positive correlations were seen between EphB4, MMP3, and MIF (p<0.0001). Atrophy and follicular pathology were more frequent in H. pylori + biopsies (p<0.0001), while intestinal metaplasia and CDX2 expression showed no significant correlation with H. pylori status. Antral biopsies demonstrating atrophy, intestinal metaplasia, and/or aberrant CDX2 expression were seen in 21.95 % (18/82) of the children, potentially identifying those who would benefit from closer surveillance and preventive dietary strategies. Biomarkers CDX2, EphB4, MMP3, and MIF may be useful in the work-up of pediatric gastritis.

The Prevalence of Helicobacter Pylori in Dyspeptic Patients and the Relationship with Endoscopic Diagnosis

“…Although there are studies reported the relationship of intestinal metaplasia and H.pylori infection, some of the authors reported no relations [18][19][20][21]. As a result of the analysis of the histopathological analysis; H.pylori infection and intestinal metaplasia Similarly, there is not an accepted evidence of dominancy of any gender in literature there was not a gender dominancy of H.pylori infection.…”

Gastric Damage and Cancer-Associated Biomarkers in Helicobacter pylori-Infected Children

“…H. pylori induction of p53 expression has been described in chronic gastritis and preneoplasic lesions (such as intestinal, metaplasia and dysplasia in adults), especially those associated with CagA-positive strains (Teh et al, 2002;Li et al, 2016). Pediatric studies assessed in this review showed contradictory results, with p53 overexpressed in gastric tissue of H. pylori infected children, and directly correlated with gastritis, the magnitude of inflammatory cell infiltration and H. pylori tissue density in two studies (Ozturk et al, 2005;Saf et al, 2015); while on the other hand two other studies showed similar expression levels in infected and non-infected children (Nardone et al, 2001;Villarreal-Calderon et al, 2014).…”

“…H. pylori promotes the Wnt/β-catenin pathway through several mechanisms: by upregulating Wnt/β-catenin activators, c-Met and EGFR, by downregulating the Wnt/β-catenin suppressors, TFF1 and RUNX3, and also by recruiting tumorassociated macrophages (Song et al, 2015). Villarreal -Calderón et al, describe high membranous expression of β-catenin in gastric biopsies of H. pylori infected children as compared to non-infected controls (Villarreal-Calderon et al, 2014).…”

Review: Prevalence and dynamics of Helicobacter pylori infection during childhood

“…The cross‐sectional studies on H. pylori infection in symptomatic children as detected by histology are summarized in Figure [references: ] . H. pylori prevalence estimates vary greatly (3%‐76%) with an overall random‐effects regression model estimate of 39% (95% CI: 35%‐43%).…”

“…Among children with gastrointestinal symptoms, rates varied from 7% to 76%, with a cluster of studies, 16/43 (37%), reporting prevalence estimates of 30%‐40%. Three studies in children with gastritis or duodenitis reported a 44% positivity rate in Mexico, 46% in Russia and 20% in China . One study in Europe looked at infection rates in children with gastric or duodenal ulcers, in children <6 years old 13% were infected, in 6‐11‐year‐olds 35% and in 12‐18‐year‐olds 38% were infected .…”