Background Gastric gland mucin is important for maintaining the basic function of the gastric mucosa, protecting it from foreign substances and reducing the occurrence of gastric diseases. Exploring the phenotype of gastric gland mucus changes during the progression of gastric disease is of great clinical significance. Methods A total of 483 patients with different gastric diseases were collected in this study, including 82 superficial gastritis (SG), 81 atrophic gastritis (AG), 168 dysplasia (GD), and 152 gastric cancer (GC). Mucin staining was performed using HID-ABpH2.5-PAS method and was further grouped according to the mucin coloration. Results The phenotypic characteristics of mucin during disease progression were divided into neutral, acidic, and mucus-free types. Furthermore, acidic mucus can be divided into type I, type II, and type III. The SG group was dominated by neutral mucus (100%), and the AG was dominated by acid mucus (81.48%), which gradually increased with the severity of atrophy (P < 0.05). The GD and GC groups were dominated by mucus-free (43.45%, 78.29%), and as the degree of GD worsened, neutral and acidic mucus gradually decreased and mucus-free increased (P < 0.001). From the SG, AG, GD, and GC progression, neutral and acidic mucus gradually decreased, and mucus- free gradually increased. Acidic mucin revealed that type III (red-brown black) mucin was predominant in AG, GD, and GC, and increased with the degree of AG, GD, as well as the biological behavior of GC. In the lesion adjacent to high-grade GD or GC, type III acid mucin is predominant. Conclusion There were three mucin phenotypes in the process of gastric diseases. With the disease progression, the trend of phenotypic change was that neutral and acidic mucus gradually decreased and mucus-free increased. The appearance of type III mucin suggested a relatively serious phase of gastric diseases and may be a more suitable candidate for follow-up monitoring of patients with GC risk.

中文翻译：

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不同胃病患者胃上皮黏液表型特征：从浅表性胃炎到胃癌

背景胃腺粘蛋白对于维持胃黏膜的基本功能，保护其免受外来物质的侵害，减少胃病的发生具有重要作用。探索胃病进展过程中胃腺粘液表型的变化具有重要的临床意义。方法共收集483例不同胃病患者，其中浅表性胃炎（SG）82例，萎缩性胃炎（AG）81例，不典型增生（GD）168例，胃癌（GC）152例。使用 HID-ABpH2.5-PAS 方法进行粘蛋白染色，并根据粘蛋白颜色进一步分组。结果疾病进展过程中粘蛋白的表型特征分为中性、酸性和无粘液类型。此外，酸性粘液可分为I型、II型和III型。SG组以中性粘液为主（100%），AG组以酸性粘液为主（81.48%），随着萎缩的严重程度逐渐增加（P < 0.05）。GD组和GC组以无粘液为主（43.45%、78.29%），随着GD程度加重，中性和酸性粘液逐渐减少，无粘液增多（P < 0.001）。从SG、AG、GD、GC进展，中性和酸性粘液逐渐减少，无粘液逐渐增多。酸性粘蛋白显示III型（红棕黑色）粘蛋白在AG、GD和GC中占优势，并且随着AG、GD的程度以及GC的生物学行为而增加。在与高级别 GD 或 GC 相邻的病灶中，III 型酸性粘蛋白占优势。结论胃病过程中存在3种粘蛋白表型。随着病情的发展，表型变化的趋势是中性和酸性粘液逐渐减少，无粘液增加。III 型粘蛋白的出现表明胃病处于相对严重的阶段，可能更适合对有 GC 风险的患者进行随访监测。