in the presence of RBC, lysed RBC (which interestingly, showed enhancedgrowth), mononuclear cells or neutrophils. Plasma, however, inhibited thegrowth of H. pylori at all time points tested. No viable bacteria wererecovered from cultures incubated in the presence of plasma regardless ofthe plasma donor’s Hp antibody status.Conclusion Blood and plasma from Hp� as well as Hp� patients inhibitthe growth of Hp in liquid culture in an antibody-independent fashion, Thecomponent of plasma responsible however, remains to be determined.These data help to explain the unusual finding of the apparent low H. pyloriinfection rate in actively bleeding gastric and duodenal ulcer patients.

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Associated lesions to gastric cancer: follow-up studyMario J Dinis-Ribeiro1, Costa-Pereira A2, Lopes C1, Lomba-Viana R1*and 1Instituto Portugues de Oncologia, Porto, Portugal; and 2Facultyof Medicine of Porto, Porto, Portugal.

Purpose: Adequate follow-up for some histopathological conditions andlesions, associated with gastric cancer, is not fully defined. Aim: Toevaluate progression and follow-up of atrophic gastritis (AG), intestinalmetaplasia (IM) and dysplasia (D).Methods: Seventy-seven patients clinical files retrospective analysis withmore than one endoscopy since January 1985, in whom biopsies revealedAG; complete (c) or incomplete (i ) IM; low-grade (LGD) or high-grade D(HGD).Results: Table: Median time and histology results for each type of pre-cancerous lesion in a once made endoscopyConclusions: Patients with AG or cIM may not need a follow-up endos-copy, at least every year. Instead non-invasive tests may be usefull for theirfollow-up (eg PI/PII). On the contrary, for patients with iIM or D (8–16%progressed to HGD and C) a intensive follow-up should be developed, withimprovement of endoscopy techniques (eg, magnification).

FOLLOW-UPTime (months) Histology

AG IM IM D D CBACKGROUND C I LGD HGD

AG 24 (6–264) 41% 10% 10% 39% 0 0IM-C 12 (6–48) 25% 63% 12% 0 0 0I 36 (6–60) 14% 33% 38% 5% 5% 5%LGD 24 (6–96) 36% 4% 18% 33% 5% 4%HGD 24 (6–72) 17% 0 42% 25% 8% 8%

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Percutaneous endoscopic gastrostomy for decompression in patientswith malignant ascites and gastrointestinal obstructionCharles E Dye and Eli Ehrenpreis*. 1Gastroenterology, University ofChicago, Chicago, Illinois, United States; and 2Gastroenterology,University of Chicago, Chicago, Illinois, United States.

Purpose: The purpose of the study is to assess the safety and efficacy ofPercutaneuos Endoscopic Gastrostomy (PEG) for decompression of ob-struction in patients with malignant ascites.Methods: Eligible patients have permanent gastrointestinal obstruction andmoderate to large ascites due to terminal malignancy. Symptoms must berelieved by nasogastric tube (NGT) suction. After large volume paracen-tesis, PEG placement is performed and followed by placement of twogastropexy fastners to help assure adequate fixation during tract maturation.Large volume paracentesis is performed for moderate to large ascitesaccumulation until tract maturation occurs in 3–4 weeks. Subsequentparacentesis is performed only for palliation of abdominal pain.Results: Six patients were evaluated, five patients underwent endoscopywith consideration of PEG placement, and four patients had successfulPEG placement. PEG placement was not performed in one patient during

endoscopy due to epigastric tumor mass and failure of transcutaneousneedle localization of the gastric wall. The four patients who received PEGtubes for decompression had good relief of symptoms and no majorcomplications.Conclusions: PEG tubes can be safely placed in patients with malignantascites and gastrointestinal obstruction resulting in effective palliation ofnausea and vomiting, ability to comfortably swallow liquids, and improvedquality of life.

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Expression of COX-2 in the colonic phenotype of gastric intestinalmetaplasia (GIM) with or without gastric adenocarcinomaImran Fayyaz, MD, Zafar K. Mirza, MD, Maria T. Lee, MD and KironM. Das, MD, FACG*. 1 Medicine, UMDNJ-Robert Wood JohnsonMedical School and Hospital (RWJUH), New Brunswick, New Jersey,United States.

Purpose: Some forms of gastric intestinal metaplasia (GIM) may beprecancerous. It is clinically important to determine the subtype of GIMthat can lead to gastric cancer. COX-2 expression in the GIM and itsrelation to GIM-phenotype is unknown. We have developed a monoclonalantibody (mAb Das-1) that specifically reacts with normal colonic andBarrett’s epithelium, but not with any other part of the gastrointestinal tract,including stomach and small intestine (Ann Int Med 120:753, 1994).Methods: Using anti-COX-2 antibody, by an immunoperoxidase assay, weexamined COX-2 expression in histologically confirmed GIM specimens(biopsy and surgical) with and without gastric cancer. Phenotype of GIMwas examined in parallel using mAb Das-1. Patients included, Group A:GIM without gastric carcinoma (n � 26), Group B: GIM away from gastriccancer area (n � 8).Results: COX-2 expression was present in 12 of the 26 (46%) specimensof GIM without cancer, and 5 out of 8 (62%) GIM specimens with cancer.mAb Das-1 reactivity was present in the GIM in 14/26 in Group A and 8/8in Group B patients. It is intriguing that COX-2 expression was noted onlyin the GIM reactive to mAb Das-1.Conclusions: COX-2 expression is present in GIM, more frequently incancer patients, and its expression is strongly associated with colonicphenotype of GIM.

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Gastric intestinal metaplasia as detected by a novel biomarker ishighly associated with gastric adenocarcinomaImran Fayyaz, MD, Zafar K. Mirza, MD, Maria T. Lee, MD and KironM. Das, MD, FACG*. 1Medicine, UMDNJ-Robert Wood JohnsonMedical School and Hospital (RWJUH), New Brunswick, New Jersey,United States.

Purpose: Some forms of gastric intestinal metaplasia (GIM) may beprecancerous. However the cellular phenotype that predisposes to gastriccarcinogenesis is unknown. A monoclonal antibody (mAb Das-1, IgMisotype) specifically reacts with normal colonic and Barrett’s epithelium,but not with normal stomach esophagus and small intestine (Ann Int Med120:753, 1994). We examined if mAb Das-1 can identify sub-type of GIMassociated with gastric carcinoma.Methods: Using mAb Das-1, by a sensitive immunoperoxidase assay, weexamined histologically confirmed GIM specimens (biopsy and surgical-)from RWJUH. Patients included, Group A: GIM (without gastric carci-noma) (n � 26), Group B: GIM associated with gastric cancer, but awayfrom cancer area (n � 8).Results: In Group A, 14 of 26 (53.8%) samples, the glandular epitheliumin GIM clearly reacted with mAb Das-1. In Group B, all 8 samples (100%)of GIM areas away from gastric carcinoma reacted intensely with mAbDas-1 (p � 0.05). In addition, each of 8 gastric carcinoma tissue also

S53AJG – September, Suppl., 2001 Abstracts