Brief Article
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World J Gastroenterol. Jan 21, 2013; 19(3): 404-410
Published online Jan 21, 2013. doi: 10.3748/wjg.v19.i3.404
Magnifying chromoendoscopy combined with immunohistochemical staining for early diagnosis of gastric cancer
Xian-Mei Meng, Yi Zhou, Tong Dang, Xu-Yang Tian, Jie Kong
Xian-Mei Meng, Yi Zhou, Tong Dang, Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China
Xian-Mei Meng, Yi Zhou, Tong Dang, Institute of Digestive Diseases of Inner Mongolia Autonomous Region, Baotou 014030, Inner Mongolia Autonomous Region, China
Xu-Yang Tian, Jie Kong, Department of Pathology, The Second Affiliated Hospital of Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China
Author contributions: Meng XM contributed to conception and design, analysis and interpretation of data; Zhou Y contributed to data gathering, analysis and interpretation of the data, drafting the article; Dang T contributed to conception and design, final approval of the article; Tian XY contributed to immunohistochemistry stain, analysis and interpretation of immunohistochemistry data; Kong J contributed to immunohistochemistry stain.
Supported by Grant from the Medical and Health Research Program of Inner Mongolia Autonomous Region, No. 2010069
Correspondence to: Tong Dang, Professor, Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China. yizhou1019@163.com
Telephone: +86-472-3169706 Fax: +86-472-3169530
Received: November 7, 2012
Revised: December 7, 2012
Accepted: December 15, 2012
Published online: January 21, 2013
Abstract

AIM: To assess the diagnostic value of using magnifying chromoendoscopy combined with immunohistochemical staining of proliferating cell nuclear antigen (PCNA) and p53 in the detection of gastric precancerous lesions.

METHODS: Ninety-five patients who were treated for abdominal discomfort, abdominal pain, bloating, and acid reflux at our hospital from January 2010 to December 2011 were included in the study. An ordinary gastroscopic procedure was initially performed to select the lesions. All subjects underwent magnifying chromoendoscopy to observe morphological changes of gastric pits. Biopsies were then taken from each area of interest and sent for pathological examination and detection of PCNA and p53 expression by immunohistochemistry. An immunoreactivity score for each lesion was calculated. Based on immunoreactivity scores, immunohistochemical staining was then considered.

RESULTS: Compared to intestinal metaplasia, gastric pits were more diverse in size, more irregular in shape, and more disorderly in arrangement in moderate and severe dysplasia. PCNA and p53 expression was significantly higher in precancerous lesions (intestinal metaplasia and dysplasia) than in chronic gastritis. PCNA expression showed an upward trend in types A-F pits. The number of cases that showed strong PCNA positivity increased significantly with an increase in the severity of lesions. Rank sum test for independent samples showed that p53 expression was significantly higher in types E and F pits than in types A-D pits (H = 33.068, P = 0.000). Rank sum test for independent samples showed that PCNA expression was significantly higher in types E and F pits than in types A-D pits (H = 31.791, P = 0.001).

CONCLUSION: The presence of types E and F pits, in which p53 and PCNA are highly expressed, is highly suggestive of the occurrence of early cancer, and patients developing these changes should be closely followed.

Keywords: Magnifying chromoendoscopy, Gastric precancerous lesions, p53, Proliferating cell nuclear antigen, Early gastric cancer