IMMUNOHISTOPATHOLOGICAL ROLE OF BCL2 AND P53 GENE EXPRESSION IN HELICOBACTER PYLORI CYTOTOXIN-ASSOCIATED GENE A POSITIVE VERSUS CYTOTOXIN-ASSOCIATED GENE A NEGATIVE ANTRAL PREDOMINANT NON-ATROPHIC GASTRITIS IN IRAQI PATIENTS

摘要

Objectives: To determine the role of Bcl2 and p53 gene expression in the pathogenesis of antral-predominant non-atrophic gastritis (APNG) according to Helicobacter pylori (HP) cytotoxin-associated gene A (CagA) status. Methods: Multiple antral biopsies were taken from 78 patients for rapid urease test, histopathology, Bcl2 and P53 immunohistochemistry and HP CagA in situ hybridization. Results: CagA was detected in 74.35% cases. There was no significant difference in Bcl2 expression among CagA+ and CagA? APNG cases. Significant differences in polymorphonuclear neutrophils (PMNs) and lymphocytes grades were detected among CagA+ and CagA? APNG cases. There was no significant correlation among patients’ age, inflammatory infiltrates, Bcl2, p53 expression. CagA has positive correlation with p53 (p=0.001), PMNs grade (p=0.027), lymphocytes grade (p=0.003), inflammation intensity (p=0.006), and inflammation activity (p=0.007). Bcl2 has no significant correlation with p53, CagA, PMNs, and lymphocytes indexes. P53 expression has significant correlation with PMNs and lymphocyte grades (p=0.000), inflammation intensity (p=0.003), and inflammation activity (p=0.002). PMNs grade has positive correlation with lymphocyte grade, inflammation intensity, and activity (p=0.000). Lymphocyte grade has a significant correlation with inflammation intensity and activity (p=0.000). Inflammation intensity has a significant correlation with inflammation activity (p=0.000). Conclusions: CagA cytotoxin has direct effect on P53 gene and indirect effect on Bcl2 gene expression in APNG cases. Bcl2 and P53 expression do not get affected by patient’s age and gender. PMNs grade, lymphocytes grade, inflammation intensity, and inflammation activity affected directly by P53 and CagA cytotoxin expression and indirectly by Bcl2 expression. The balance of P53-Bcl2 pathways play a vital role in pathogenesis of HP and CagA-induced APNG. Keywords: Antral-predominant non-atrophic gastritis, Bcl2, p53, Helicobacter pylori, Cytotoxin-associated gene A.