Abouda, G.F.; Dillon, J.F.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA37
Academic Journal
Background: The factors involved in the progression of GORD to Barrett's oesophagus, and then to oesphageal adenocarcinoma are still unclear, however, gastric and bile reflux, cytokines (IL-1 B, TNF-α), and inflammatory mediators eg PGs are known to play a role. COX2 activity has been shown to effect cell turnover in oesphageal cancer. Previous studies have also shown that COX2 is induced by H pylori in the stomach. Aim of Work: To study COX2 expression in patients with reflux symptoms and Barrett's oesophagus, and correbte this with their helicobacter status. Method: 53 patients with reflux symptoms, 35 Barrett's patients and 20 non-reflux control patients were recruited. For purpose of analysis we divided the reflux group into GORD and NERD, 33 and 20 respectively. During an upper Gl endoscopy, biopsies were taken from the oesophagus, the gastric body and antrum of each patient. CLO test, ELISA and, histopathology were used to assess the H pylori status. COX2 estimation was carried out by ELISA on the oesophageal and antral biopsies. Results: COX2 was expressed more in Barrett's (mean value 412 ng/ul) than in GORD patients (mean value of 312 ng/ul) (p < 0.005) this difference was more evident in patients with dyspbsia. COX2 expression was higher in GORD patients than NERD (mean value of 245 ng/ul) (p < 0.005), whereas control group expressed minimal levels of COX2 (mean value of 187.5 ng/ul). When comparing these results with H pylori status, COX2 expression was greater in oesphageal biopsies for both reflux and Barrett's in H pylori +ve (370 ng/ul, and 450 ng/ul, respectively) than H pylori -ve patients (237 ng/ul and 392 ng/ul, repectivley). In H pylori +ve patients COX2 was expressed at a greater level in the oesphageal biopsies compared with antral biopsies (450 ng/ul vs 240ng/ul), for H pylori -ve patients this trend was less marked. Conclusion: COX2 is over expressed in the oesophagus, in GORD and Barretts this is exaggerated further by H pylori...


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