Abstract
AIM: To evaluate the optimal intervention point of a selective cyclooxygenase-2 (COX-2) inhibitor, celecoxib, for inhibiting Helicobacter pylori (H. pylori)-associated gastric carcinogenesis in Mongolian gerbils (MGs). METHODS: One hundred and twelve MGs were divided into six groups (A-F). One hundred gerbils were inoculated with H. pylori (groups A-E). Twelve gerbils were inoculated with vehicle broth only (group F). After 4 wk, they were given N'-methyl-N'-nitro-N-nitroso-guanidine (MNNG) (50 microg/mL) in the drinking water for 20 wk. In groups B-E, the animals were given the stock celecoxib (10 mg/kg per day) diet from the 21st, 31st, 21st and 41st week respectively. The periods of administering celecoxib were 30, 20, 20, and 15 wk respectively. On the 51st week, the animals were sacrificed for histological examination. Local PCNA expression was examined by the immunohistochemistry method. The expression of COX-2 protein was assessed by western blot. Analysis used the chi(2) test. The difference was regarded as significant when P value was less than 0.05. RESULTS: Seventeen percent (17/100) of H. pylori-infected MGs developed gastric cancer. All of these lesions were well-differentiated adenocarcinoma. The incidence rates of adenocarcinoma in groups A-F were 40%, 0%, 0%, 20%, 25%, and 0% respectively. The inflammatory scores were higher in group B than in other groups. There was no inflammatory response noted in group F. Celecoxib treatment resulted in a significant reduction in the proliferation of H. pylori-infected mucosal cells (groups B, C and D) (P < 0.01). The expression of COX-2 protein was significantly attenuated in the groups which were celecoxib-treated for more than 20 wk (groups B, C, D). The groups treated with celecoxib had a significantly lower rate of advanced gastric cancer (34% vs 75%, P < 0.001) There were no sudden deaths in any of the groups. CONCLUSION: Short-term treatment with celecoxib has an anti-carcinogenic effect, and resulted in less severe inflammation and inhibited the invasive degree of gastric cancer.