Expression of Cytokeratins 7 and 20 in Helicobacter pylori-associated Chronic Gastritis in Children

Abstract

Helicobacter pylori gastric infection induces structural changes in the gastric epithelium. Among them, variations in the expression of cytokeratins have been reported in adult patients. In the present study, we describe the expression of CK7 and CK20 in gastric samples taken from the antrum in three groups of pediatric patients: (A) Helicobacter pylori-associated chronic gastritis (mean age: 11.4 years); (B) previous H. pylori chronic gastritis patients (mean age: 9.4 years); and (C) controls (mean age: 8.8 years). In all, the presence of sulfomucins was assessed with Alcian blue-periodic acid-Schiff pH 1.0. Immunoreactivity was graded as absent (0), weak (1+), moderate (2+), or intense (3+), in accordance with the intensity of the staining, and its distribution as focal or diffuse. CK7 reactivity was 2+ either focal or diffuse in all group A biopsies. The reactivity was more evident in the cells at the neck of the glands, in the areas with more inflammatory infiltrates, decorating long vertical segments of epithelium. In groups B and C, CK7 reactivity was also focal and 1+ at the cells of the necks of the glands. However, group B presented longer vertical segments of positive cells as compared to group C, and shorter than those of group A. The deeper glandular structures were focally 1+ in both groups. CK20 expression was comparable in all three groups, depicting a 2+ diffuse reactivity at the surface epithelium and interposed pits with absence or focal reactivity at the neck and coiled gland areas. Ki-67 immunostaining paralleled that of the CK7. Staining for sulfated mucosubstances was positive in two of five cases of groups A and B, and in none of the cases of group C. We conclude that: (1) the long segments of CK7-positive glandular necks in H. pylori cases most probably indicate intense regenerative activity during active inflammation; (2) eradication of H. pylori does not warrant ad integrum restitution since long segments of Ki-67+, CK7+ cells at the germinative compartment of the glands (as well as cells with sulfomucins) were still recognizable in ex- H. pylori patients; (3) finally, differing from what happens in adults, children somehow manage to maintain fully differentiated CK20+ superficial epithelium while the H. pylori is in action.

Altered expression of CK7 and CK20 in preneoplastic and neoplastic lesions in ulcerative colitis

“…The frequent association of CK7 expression with epithelial areas connected with active inflammation is noteworthy. Similar results have been observed in biopsies from the gastric mucosa in a study of patients with gastritis (28).…”

Systematic Review and Meta‐analysis of Histological Gastric Biopsy Aspects According to the Updated Sydney System in Children

“…Only 17 studies included in our review reported the presence of LF with a mean of 46.4% in H pylori-positive versus 17.8% in H pylori-negative children. Moreover, H pylori-positive children showed significantly higher 3.83 RR for LF (Table 2) (8,12,14,17,18,27,34,35). According to the literature, the presence of LF is highly specific of H pylori infection but not particularly in children (12,17,(36)(37)(38).…”

The Role of Hyperthermia in the Multidisciplinary Treatment of Malignant Tumors

“…Furthermore, there were no significant differences in overall survival (OS), local control, and freedom from distant metastases over 2 years between the 2 groups. 54,55 In a more recent trial, the prospectively randomized NCT 00003052 phase III multicenter trial, 341 patients with untreated localized high-risk STS were enrolled, of whom 169 received neoadjuvant chemotherapy consisting of etoposide, ifosfamide, and adriamycin (EIA) plus regional hyperthermia, and the remainder received EIA alone. After induction therapy, the tumor response was evaluated by imaging, and the best local treatment (surgery and/or RT) was selected, followed by another 4 cycles of induction therapy.…”

“…Furthermore, there were no significant differences in overall survival (OS), local control, and freedom from distant metastases over 2 years between the 2 groups. 54,55…”