EXPRESIÓN DE CITOCINAS Th1, Th2 Y Th3 EN BIOPSIAS OBTENIDAS DE PACIENTES CON ADENOCARCINOMA GÁSTRICO

Abstract

Introduction: There are many kinds of cancer that can be present in the stomach. The adenocarcioma is the most common in people, without taking considerations such as age, raze or medical history of the patient. Among the last years, its prevalence has increased worldwide. A great amount of clinical and molecular tests inrelation with this kind of cancer had been realized. However, tests intending to treat this pathology involving immunological response associated to this kind of malignancy had never been done before. That was the reason why an immunohistochemistry test in Mexican population was held in a third level hospital at Puebla, which could allow us to identify what kind of immunological response exists. The Objective of this work was to determine the expression of Th1, Th2 and Th3 cytokines in the biopsies of patients with gastric adenocarcioma. Process and material: A transversal, observational and exploratory study was done at the Pathology service of the Unidad Médica de Alta Especialidad Hospital de Especialidades Centro Médico Nacional General de División “Manuel Ávila Camacho”, of the Instituto Mexicano del Seguro Social, Puebla and at the Facultad de Medicina de la Benemérita Universidad Autónoma of Puebla, from January 2009 to June 2011. It was include male and female patients with gastric adenocarcioma diagnosis for histology. The patients with total gastrectomy was stratified and they were took a biopsy, which was processed and underwent hematoxylin and eosin staining and immunohistochemistry to identify the histological type and immune response associated with this type of malignancy. Results: Of the 30 biopsies from patients with gastric adenocarcinoma accounted 14 for 15 women and 15 men with age range from 31 to 88 years (average 58.34 p = 0.49). Based on the Lauren classification, 60% were diffuse, intestinal 20% and 20% mixed. 16.6% were stage I, 26.6% stage II, stage III 30% and 26.6% stage IV. Positive cases of cytokines, 23% were IL-2, 26.7% IL-4, 16.6% IL-10 and in no case was detected TGF-β positive. Cytokines in positive correlation with gender, histological grading inflammatory infiltrate and there was no statistical difference. Statistically significant differences were found only for the following variables: 100% of IL-2 positive were observed in stages I-II (p = (0.009), 87.5% of the positive IL-4 were observed in stages I -II (p = 0.005) and 100.0% of the positive IL-10 were observed in stages I-II (p = 0.009). Conclusions: In women younger men are more likely to have gastric adenocarcinoma. In gastric cancer there is a Th1 response in most men, they also present a Th2 response but in fewer cases in women and the opposite happens. Gastric cancer has a higher proportion advanced clinical stages. In early clinical stages predominantly Th2 immune response and the more advanced stages of gastric adenocarcinoma immune response is negligible.