Epithelial Cell Turnover Is Increased in the Excluded Stomach Mucosa After Roux-en-Y Gastric Bypass for Morbid Obesity

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author SAFATLE-RIBEIRO, Adriana V. FMUSP-HC
dc.date.issued 2013
dc.identifier.citation OBESITY SURGERY, v.23, n.10, p.1616-1623, 2013
dc.identifier.issn 0960-8923
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/4258
dc.description.abstract Mucosal alterations after Roux-en-Y gastric bypass for morbid obesity have not been clearly evaluated. This study aims to analyze the mucosal alterations (proliferative status (Ki-67); apoptosis (caspase-3 and BCL-2); hormonal function (gastrin)) in the excluded stomach. Double-balloon enteroscopy was performed in 35 patients who underwent Roux-en-Y gastric bypass longer than 36 months. Multiple biopsies of the proximal pouch and the excluded gastric mucosa were collected. Gastric biopsies from 32 non-operated obese patients were utilized as controls. Endoscopic biopsies were cut from tissue blocks fixed in formalin and embedded in paraffin. Sections 4 mu m thick were examined for immunoexpression using the streptavidin-biotin-peroxidase method. The two groups were comparable for age, gender, gastritis, intestinal metaplasia, and Helicobacter pylori. The mean number of positive gastrin cells was 55.5 (standard deviation (SD) = 11.7) in the control group and 29.6 (SD = 7.9) in the cases, p = 0.0003. Ki-67 proliferative index in cases (body = 24.7 %, antrum = 24.9 %) was significantly higher compared to controls (body = 15.0 % and antrum = 17.7 %), p = 0.002 and 0.01, respectively. Caspase-3 immunoexpression was higher in the controls compared to the excluded stomach (46 vs. 31 %), p = 0.02. There was no statistical difference between CD3, CD8, and Bcl-2 immunoexpressions in the control and cases. Cell proliferation is increased and apoptosis is downregulated in the excluded gastric mucosa compared to the non-operated obese controls. Alterations in cell turnover and in hormonal secretions in these conditions may be of relevance in long-term follow-up.
dc.description.sponsorship · Foundation of Support to the Research of the State of Sao Paulo (FAPESP) [06/53741-4]
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Obesity Surgery
dc.rights restrictedAccess
dc.subject Morbid obesity; Double-balloon endoscopy; Enteroscopy; Roux-en-Y gastric bypass; Ki-67; Caspase-3; Bcl-2; Gastrin
dc.subject.other bariatric surgery; cancer; lesions; epidemiology; gastrectomy; expression; carcinoma; segment; access; risk
dc.title Epithelial Cell Turnover Is Increased in the Excluded Stomach Mucosa After Roux-en-Y Gastric Bypass for Morbid Obesity
dc.type article
dc.rights.holder Copyright SPRINGER
dc.description.group LIM/35
dc.description.group LIM/37
dc.description.group LIM/50
dc.identifier.doi 10.1007/s11695-013-0975-2
dc.identifier.pmid 24022341
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author SAFATLE-RIBEIRO, Adriana V.:HC:ICESP
hcfmusp.author PETERSEN, Pedro A.:HC:IOT
hcfmusp.author PEREIRA FILHO, Dilson S.:FM:
hcfmusp.author CORBETT, Carlos E. P.:FM:MPT
hcfmusp.author FAINTUCH, Joel:FM:MGT
hcfmusp.author ISHIDA, Robson:HC:ICHC
hcfmusp.author SAKAI, Paulo:FM:MGT
hcfmusp.author CECCONELLO, Ivan:FM:MGT
hcfmusp.author RIBEIRO JR., Ulysses:FM:MGT
hcfmusp.origem.id WOS:000324230800018
hcfmusp.origem.id 2-s2.0-84884672821
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
hcfmusp.citation.scopus 9
hcfmusp.citation.wos 11

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