Morphological features of the gastric mucosa capillary network in patients with portal hypertension

• Published in: Arkhiv patologii Vol. 73; no. 4; p. 43
• Main Authors: Khomeriki, S G, Zhukov, A G
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01.07.2011
• Subjects: Adult; Aged; Antigens, CD34 - metabolism; Capillaries - metabolism; Capillaries - pathology; Capillaries - physiopathology; Cell Proliferation; Female; Gastric Mucosa - blood supply; Gastric Mucosa - metabolism; Gastric Mucosa - pathology; Humans; Hypertension, Portal - metabolism; Hypertension, Portal - pathology; Hypertension, Portal - physiopathology; Ki-67 Antigen - metabolism; Male; Middle Aged; Vascular Endothelial Growth Factor Receptor-1 - metabolism
• ISSN: 0004-1955

The pathogenesis of portal hypertension (PH) involves venous congestion with gastric mucosal capillary dilatation. The formation of new blood vessels, as was shown in experimental models of PH, is pathological hallmark of PH. Generation of new blood vessels is stimulated by vascular endothelial growth factor (VEGF), the regulator of angiogenesis. The aim of the study was to investigate changes in gastric microvessels in patients with liver cirrhosis complicated with PH in different stages, and the factors influencing the development of portal hypertensive gastropathy. We studied the relation between gastric mucosal capillary parameters, measured morphometrically, and endoscopic appearances in 56 patients with PH. The gastric biopsy was obtained from antrum and corpus of the stomach. We determined expression and localization of Fit-1 receptor for VEGF in human gastric mucosa by immunohistochemistry. Mucosal capillary network assessed on histological sections immunostained for CD34, a specific marker for endothelial cells and revealed proliferating endothelial cells by Ki-67 antibodies. Nicon CP 995 camera and digital image analyzing system (DMI-1) was used for morphometry. The number, size and relative volume of vessels in gastric mucosa were evaluated. Helicobacter pillory-positive patients were excluded from study. The number of vessels in gastric mucosa was significantly higher in groups with PH (p < 0.05) compared with patients without PH. The mean size of vessels in gastric mucosa was decreased in patients with PH (212 +/- 20 vs 282 +/- 25 mkm2, p < 0.05) in atrum and (155 +/- 12 vs 198 +/- 13 mkm2, p < 0.039) in corpus. The majority of the vessels were presented by newly formed small sized capillaries. Meanwhile the relative volume of vessels in gastric mucosa was not changed significantly in groups with PH. These observations have not supported the view that PH is usually associated with a prominent dilatation of gastric mucosal capillaries. Our data have shown intensifying of neoangiogenesis in human gastric mucosa at PH. The anti-angiogenic therapeutic approach could be taken into consideration for patients suffering from PH.