Spasmolytic polypeptide-expressing metaplasia associated with higher expressions of miR-21, 155, and 223 can be regressed by Helicobacter pylori eradication in the gastric cancer familial relatives.

Background and aimsSpasmolytic polypeptide-expressing metaplasia (SPEM) is a preneoplastic gastric cancer lesion related to epigenetic microRNA (miRNA) expression. This study elucidated whether Helicobacter pylori-infected first-degree relatives of patients with gastric cancer (GCF) are susceptible to have SPEM and correlated with miR-21, 155, and 223 expressions. We also validated whether SPEM and these miRNAs can be regressed after Hpylori eradication. MethodsWe prospectively enrolled 148 GCF and 148 nonulcer dyspepsia (NUD) subjects without gastric cancer familial history as controls. Each case had received a panendoscopy to determine Hpylori status and gastric histology, including SPEM. The cases with SPEM were followed after Hpylori eradication to determine SPEM regression. The total RNA was extracted to analyze tissues miR-21, 155, and 223 before and after eradication. ResultsGCF subjects had a higher prevalence of Hpylori infection (73% vs 32%) and SPEM (42% vs 14%, P<0.01) than controls. The tissue miR-21, 155, and 223 in antrum were higher in cases with SPEM than in those without SPEM (P<=0.05). There was similar SPEM reversibility after Hpylori eradication between GCF subjects and controls (72% vs 69%, P=0.852). In the SPEM regressed cases, tissue miR-21, 155, and 223 decreased after Hpylori eradication (P<0.05). ConclusionThe H pylori-infected GCF subjects were prone to have SPEM with higher tissues miR-21, 155, and 223 expressions. Hpylori eradication can result in a 70% SPEM regression, accompanied by a decline in miR-21, 155, and 233 expression levels.