Preferential expression of cyclooxygenase-2 in colonic-phenotype of gastric intestinal metaplasia: association with helicobacter pylori and gastric carcinoma

J Clin Gastroenterol. 2006 Feb;40(2):122-8. doi: 10.1097/01.mcg.0000196461.15186.0d.


Objectives: Gastric intestinal metaplasia (GIM) associated with H. pylori (HP) has been considered a premalignant lesion. However, GIM phenotype associated with HP infection and gastric cancer is unclear. The expression of COX-2 in relation to GIM phenotype is also unknown.

Methods: We evaluated cellular phenotype and COX-2 expression in the GIM from HP-positive and -negative patients from Japan in the absence of gastric cancer (n = 31) by using a colon epithelium specific monoclonal antibody (mAb Das-1) and anti-COX-2 antibody. COX-2 expression was also examined in patients with gastric cancer (n = 34), both in the cancer and in the GIM areas away from the cancer field.

Results: Sixty-eight percent of HP-positive GIM reacted with mAb Das-1, whereas the reactivity in the HP-negative GIM was only 25% (P < 0.001). The COX-2 expression was present in 32% of HP-positive GIM and in only 9% of HP-negative GIM (P < 0.001). In the cancer group, COX-2 expression was localized both in the cancer area (94%) and in the GIM (82%) away from the cancer. Each of the COX-2-positive tissue was also positive to mAb Das-1.

Conclusion: HP infection is highly associated with the development of colonic-phenotype of GIM, and about half of them expressed COX-2. COX-2 expression was frequent in both gastric cancer and the GIM adjacent to the cancer. The results suggest that the presence of mAb Das-1 and COX-2 reactivity in the GIM identify the subgroup of patients who may be at risk for gastric cancer and may need close surveillance.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenocarcinoma / enzymology
  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / microbiology
  • Antibodies
  • Cyclooxygenase 2 / metabolism*
  • Gastric Mucosa / enzymology
  • Gastric Mucosa / metabolism*
  • Helicobacter Infections / enzymology
  • Helicobacter Infections / metabolism*
  • Helicobacter pylori / metabolism*
  • Humans
  • Metaplasia / enzymology
  • Metaplasia / metabolism*
  • Metaplasia / microbiology
  • Phenotype
  • Precancerous Conditions / enzymology
  • Precancerous Conditions / metabolism*
  • Precancerous Conditions / microbiology
  • Staining and Labeling
  • Stomach Neoplasms / enzymology
  • Stomach Neoplasms / metabolism*
  • Stomach Neoplasms / microbiology


  • Antibodies
  • DAS-1 protein, human
  • Cyclooxygenase 2