Clinical and Endoscopic, Morphologic and Immunohistochemical Features of Gastric Ulcer in H. Pylori-Infected Individuals Receiving Cytotoxic Therapy
Sazonova, O.V.; Davydkin, I.L.; Osadchuk, A.M.; Gritsenko, T.A.
Eksperimental'naia i Klinicheskaia Gastroenterologiia 2: 18-24
2016
ISSN/ISBN: 1682-8658 PMID: 27301111 Document Number: 688526
In the article is considered theoretical and practical significances of discovery of Russian academician A. M. Ugolev in 1959 of intestinal membrane digestion. After this discovery the idea of "digestive-transport conveyor" in the small intestine was formulated. Consequence of this the development and introduction in the clinical practice of enteral nutrition method had become. Today in hospitals are used more 300 different enteral nutrition formulas. Now enteral nutrition are prescribed in different clinical conditions. Parenteral nutrition is used only when the performing of enteral feeding is impossible. To determine the prognostic significance of the expression of molecules of PCNA, Bcl-2, NF-Kb and tachykinins (substance P, neurokinin A) in patients with gastric ulcer (CU) receiving cytotoxic therapy. Total surveyed 90 patients divided into 3. equal groups. The first comparison group consisted of patients with chronic atrophic H. pylori-associated gastritis (CAG) (30 pers.). A second control group consisted of patients with gastric ulcer (30 pers.). Third, the study group consisted of 30 people. with CU suffering from hematological malignancies, in a period of complete clinical remission of the disease and receiving supportive polychemotherapy (PCT). Patients underwent endoscopy, morphological and immunohistochemical study of the mucous membrane of the antrum and body of the stomach to detect the expression of molecules of PCNA, Bcl-2, neurokinin A, substance P and factor Nf-Kb. The total level of dyspeptic syndrome on visual scale analogue in patients receiving chemotherapy and GU (GUpct) was significantly higher (p < 0.05) compared with patients with GU. It should be noted that patients with GUpct reducing clinical symptoms is much slower (p < 0.05). At the same time in 13 (43.3%) patients with GUpct determines the duration of ulcer healing, whereas in patients with GU in only 4 (13.3%) patients. Patients with GUpct more frequently (p < 0.05) were verified II and stage Ill chronic gastritis (CG), while Stage I--less (p < 0.05). Patients with GUpct significantly more often (p<0.05) was determined by the II degree of CG and significantly less (p < 0.05)--IV degree. Patients with GUpct determined significantly lower (p < 0.05), the expression performance PCNA, substance P and neurokinin A and higher (p < 0.05)--Bcl-2 and factor Nf-kB. GU in patients receiving chemotherapy, dyspeptic syndrome is characterized by severe, advanced stage of CG on the background of relatively low severity of CG in accordance with the classification of OLGA (2008). Patients with GUpht have a significant level of violation of regeneration changes how is this atrophy, intestinal metaplasia, dysplasia of gastric mucosa association with gross violations of the processes of epithelial cell homeostasis of epithelial cells regulation after molecules PCNA, Bcl-2, NF-kB and tachykinins (substation P, neurokinin A).