ORIGINAL ARTICLE

Aberrant epithelial expression of trefoil family factor 2 and mucin 6 in Helicobacter pylori infected gastric antrum, incisura, and body and its association with antralisation

H H-X Xia¹, Y Yang¹, S K Lam¹, W M Wong¹, S Y Leung², S T Yuen², G Elia³, N A Wright³ and B C-Y Wong¹

¹ Department of Medicine, The University of Hong Kong, Hong Kong, SAR China
² Department of Pathology, The University of Hong Kong, Hong Kong
³ Histopathology Unit, Cancer Research UK, London WC2A 3PX, UK

Correspondence to:
Correspondence to:
Dr B C-Y Wong
University Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong; bcywong{at}hku.hk

Aims: To determine gastric expression of trefoil family factor 2 (TFF2) and MUC6 in Helicobacter pylori positive and negative subjects, and its association with antralisation at the gastric incisura.

Methods: Gastric biopsies from the antrum, incisura, and body of 76 dyspeptic patients without ulcers were used for the determination of H pylori infection, histological changes, and epithelial TFF2 and MUC6 expression.

Results: In the foveola, the rates of TFF2 and MUC6 immunostaining were greater in H pylori infected (n = 27) than in uninfected patients (n = 49) at the antrum (59.3% v 4.1% for TFF2 and 63.0% v 4.1% for MUC6; both p < 0.001) and incisura (44.4% v 2.0% for TFF2 and 48.1% v 0% for MUC6; both p < 0.001). In the deeper glands, the rates were also greater in H pylori infected than in uninfected patients at the incisura (85.2% v 22.4% for both TFF2 and MUC6; p < 0.001). Antral-type mucosa was present at the incisura in 28 of the 76 patients. TFF2 and MUC6 expression in the foveola and deeper glands was significantly associated with antral-type mucosa, independent of H pylori status.

Conclusions: Helicobacter pylori infection increases the expression of TFF2 and MUC6 in the gastric epithelium. Aberrant TFF2 and MUC6 expression is associated with antralisation of gastric incisura.

Abbreviations: CI, confidence interval; OR, odds ratio; SPEM, spasmolytic polypeptide expressing metaplastia; TFF, trefoil family factor

Keywords: Helicobacter pylori; trefoil family factor 2; MUC6; antralisation

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