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
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 CagAâˆ’ APNG cases. Significant
differences in polymorphonuclear neutrophils (PMNs) and lymphocytes grades were detected among CagA+ and CagAâˆ’ APNG cases. There was no
significant correlation among patientsâ€™ 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 patientâ€™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
Keywords: Antral-predominant non-atrophic gastritis, Bcl2, p53, Helicobacter pylori, Cytotoxin-associated gene A.
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