Original Article
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World J Gastroenterol. Jan 28, 2011; 17(4): 449-458
Published online Jan 28, 2011. doi: 10.3748/wjg.v17.i4.449
Ghrelin and gastrin in advanced gastric cancer before and after gastrectomy
Anna Zub-Pokrowiecka, Kazimierz Rembiasz, Peter C Konturek, Andrzej Budzyński, Stanisław J Konturek, Marek Winiarski, Władysław Bielański
Anna Zub-Pokrowiecka, Kazimierz Rembiasz, Peter C Konturek, Andrzej Budzyński, Stanisław J Konturek, Marek Winiarski, Władysław Bielański, Department of Physiology, Medical College, Jagiellonian University, 31-531, Cracow, Poland
Anna Zub-Pokrowiecka, Kazimierz Rembiasz, Peter C Konturek, Andrzej Budzyński, Stanisław J Konturek, Marek Winiarski, Władysław Bielański, 2nd Department of General Surgery, Medical College, Jagiellonian University, 31-531, Cracow, Poland
Anna Zub-Pokrowiecka, Kazimierz Rembiasz, Peter C Konturek, Andrzej Budzyński, Stanisław J Konturek, Marek Winiarski, Władysław Bielański, Department of Medicine, Thuringia Clinic Georgius Agricola Saalfeld Teaching Hospital University Jena, 07318, Saalfeld, Germany
Author contributions: Zub-Pokrowiecka A, Rembiarz K, Winiarski M and Budzyński A interviewed and examined patients; Konturek PC and Bielański W performed reverse transcption-polymerase chain reaction and radioimmunoassays; Konturek SJ designed the study and drafted the manuscript; all authors read and approved the final manuscript.
Supported by The Ministry of Science and Higher Education in Poland Grant K/PBP/000012 for 2006-2008 and by Jagiellonian University Medical College Research Project for 2006-2009
Correspondence to: Stanislaw J Konturek, Professor MD, Department of Physiology, Medical College, Jagiellonian University, Grzegorzecka 16, 31-531, Cracow, Poland. mpkontur@cyf-kr.edu.pl
Telephone: +48-12-605604 Fax: +48-12-211578
Received: June 4, 2010
Revised: August 6, 2010
Accepted: September 13, 2010
Published online: January 28, 2011
Abstract

AIM: To investigate plasma ghrelin, gastrin and growth hormone secretagogue receptor (GHS-R) expression in advanced gastric cancer (GC) before and after resection.

METHODS: Seventy subjects in whom endoscopy of the upper gastrointestinal tract was performed in the Department of General Surgery at Cracow University during the past decade: (1) 25 patients with GC associated with Helicobacter pylori (H. pylori) infection; (2) 10 patients with GC 4-5 years after (total or subtotal) gastrectomy; (3) 25 healthy H. pylori-negative controls, matched by age and BMI to the above two groups; and (4) 10 GC patients 4-5 years after total gastrectomy. Ghrelin and gastrin plasma concentrations were measured by specific radioimmunoassay under fasting conditions and postprandially at 60 and 90 min after ingestion of a mixed meal. GHS-R expression was examined in biopsy samples from intact healthy mucosa and GC tissue using semi-quantitative reverse transcription-polymerase chain reaction.

RESULTS: In healthy controls, fasting plasma ghrelin levels were significantly elevated and declined markedly at 60 and 90 min after a mixed meal. The concomitant enhanced ghrelin, GHS-R and gastrin expression in GC tissue over that recorded in intact mucosa, and the marked rise in plasma gastrin in these subjects under fasting conditions indicate the role of these hormonal factors in GC formation. Fasting plasma levels and postprandial response of ghrelin and gastrin appear to be inversely correlated in healthy subjects. Feeding in the controls resulted in a significant fall in plasma ghrelin with a subsequent rise in plasma gastrin, but in H. pylori-positive GC patients submitted to total or distal gastrectomy, feeding failed to affect significantly the fall in plasma ghrelin that was recorded in these patients before surgery. Fasting ghrelin concentrations were significantly lower in patients 4-5 years after total gastrectomy compared to those in healthy controls and to these in GC patients before surgery.

CONCLUSION: Elevated plasma gastrin and suppression of fasting ghrelin in patients with GC suggest the existence of a close relationship between these two hormones in gastric carcinogenesis.

Keywords: Ghrelin; Gastrin; Gastric cancer; Gastric resection