Patterns of sialyl-Lewis X expression predict gastric histopathology

Q: What is the main goal of using sialyl-Lewis X in this study?

To identify expression patterns of sialyl-Lewis X that can detect and distinguish human gastric pre-cancerous lesions and refine histologic assessment of severity.

Q: How were gastric biopsies processed and evaluated?

Biopsies from the gastric corpus and/or antrum were stained with hematoxylin/eosin and with a commercially available antibody to sialyl-Lewis X, then graded using consensus criteria based on presence, intensity, and glandular distribution.

Q: What diagnostic relationships were reported for sialyl-Lewis X?

Presence of sialyl-Lewis X was used to detect gastric pathology with high sensitivity, and absence could reliably predict normal histology with specified specificity.

Sep 23, 2026

Uploaded by Fahsai

The work establishes diagnostic patterns of sialyl-Lewis X (sLex) expression to detect and distinguish human gastric pre-cancerous lesions. It evaluates gastric corpus and/or antrum biopsies from 149 dyspeptic adults, staining tissue for hematoxylin/eosin and a commercially available anti-sLex antibody. Histology is classified as normal, chronic non-atrophic gastritis, or chronic atrophic gastritis with or without intestinal metaplasia and assessed using presence, intensity, and glandular distribution of sLex. sLex enables high sensitivity for gastric pathology, while absence supports reliable identification of normal histology.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Gastric cancer progression and need for validated histologic markers

Role of Helicobacter pylori and lesion dynamics

Methods

Patient selection and biopsy staining

Histologic classification and sLex grading

Statistical modeling

Results

Prevalence of gastric pathology

Diagnostic performance of sLex presence and absence

Associations between sLex intensity and lesion severity

Antrum glandular distribution patterns

Conclusion

Vargas et al. Diagnostic Pathology (2025) 20:76 [https://doi.org/10.1186/s13000-025-01673-8](https://doi.org/10.1186/s13000-025-01673-8) Diagnostic Pathology RESEARCH Open Access Patterns of sialyl-Lewis X expression predict gastric histopathology Nancy Vargas1, Andrés Quiroga2, Juan Pablo Chaves2, Harold Bolaños2, ILKe Nalbantoglu3, Claudia Patricia Acosta Astaiza2, Yuefeng Wu4 and José B. Sáenz5* Abstract Introduction Gastric cancer develops through a series of pre-cancerous changes over decades of chronic inflammation. Chronic atrophic gastritis (CAG) represents a critical transition in the progression to gastric cancer, though validated histologic markers are needed to more accurately detect and assess the extent of CAG. We previously identified sialyl-Lewis X (sLex) as a marker of atrophic gastric epithelium in mice. Here, we establish patterns of sLex expression that can be used to detect and distinguish human gastric pre-cancerous lesions. Methods We obtained gastric corpus and/or antrum biopsies from 149 adult patients with dyspepsia. Biopsies were stained with hematoxylin/eosin and a commercially available antibody to sLex. Histologic diagnoses included normal, chronic non-atrophic gastritis (CNG), or CAG with or without intestinal metaplasia (IM) and were determined by a single pathologist. A second pathologist graded each biopsy according to consensus criteria, based on the presence, intensity, and glandular distribution of sLex staining. Log-linear models were used to determine the association between patterns of sLex expression and gastric pathology. Results The majority of patients (70%) had gastric pathology (CNG or CAG± IM) . The presence of sLex could be used to detect gastric pathology (97% sensitivity), and the absence of sLex staining could reliably predict normal histology (76% specificity) . The intensity of sLex staining significantly correlated with gastric pathology. Moreover, a deeper (≥ 50%) glandular sLex distribution in the antrum was significantly associated with CAG, while a more superficial (< 50%) distribution significantly correlated with CNG. Conclusion Patterns of sLex expression can be used to detect and refine the histologic assessment of gastric preneoplastic lesion severity. Keywords Gastritis, Sialyl-Lewis X, Atrophic, Chronic *Correspondence: José B. Sáenz [saenzj@wustl.edu](saenzj@wustl.edu) 1 Division of Gastroenterology, Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA 2 Departments of Physiological Sciences and Pathology, Applied Human Genetics Research Group, Universidad del Cauca, Popayán, Colombia 3 Department of Pathology, Yale University School of Medicine, New Haven, CT, USA 4 Inference Statistical Consulting LLC, St. Louis, MO, USA 5 Division of Gastroenterology, Departments of Medicine and Molecular Cell Biology, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8124, St. Louis, MO 63110, USA Introduction Gastric cancer remains a leading cause of global cancer deaths [1] . The progression to gastric adenocarcinoma occurs through a series of histologic changes, usually resulting from chronic infection with the stomach-adapted bacterium, Helicobacter pylori (H. pylori) [2, 3] . In the histologic progression to adenocarcinoma [3], it is established that certain pre-cancerous lesions, such as chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM), impact oncogenic risk [4–7] . Often, risk stratification relies on an assessment of both the topographic distribution of © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons lice

FAQs

What is the main goal of using sialyl-Lewis X in this study?

To identify expression patterns of sialyl-Lewis X that can detect and distinguish human gastric pre-cancerous lesions and refine histologic assessment of severity.

How were gastric biopsies processed and evaluated?

Biopsies from the gastric corpus and/or antrum were stained with hematoxylin/eosin and with a commercially available antibody to sialyl-Lewis X, then graded using consensus criteria based on presence, intensity, and glandular distribution.

What diagnostic relationships were reported for sialyl-Lewis X?

Presence of sialyl-Lewis X was used to detect gastric pathology with high sensitivity, and absence could reliably predict normal histology with specified specificity.

Sep 23, 2026

Uploaded by Fahsai