幽门螺杆菌、高胃泌素血症对结直肠癌形成的影响

Effects of Helicobacter pylori infection and hypergastrinemia on the pathogenesis of colorectal carcinomas

目的探讨H.pylori感染、高胃泌素血症与结直肠癌形成三者之间的相互关系及H.pylori在结直肠癌组织中的表达情况。方法采用放射免疫法(RIA)测定结直肠癌患者(51例)及对照组(43例)的血清胃泌素水平,用ELISA法检测H.pylori IgG抗体,用免疫组化的方法观察H.pylori在结直肠癌组织中的表达情况。结果肿瘤组患者H.pylori感染阳性率、血清胃泌素水平明显高于对照组(P<0.05),远端结肠与直肠患者H.pylori阳性率显著高于近端结肠患者(P<0.05),同时高胃泌素血症患者的比例明显高于近端结肠患者(77.8%vs.37.5%,80.0%vs.37.5%,P<0.05);并且随着肿瘤分期升高,二者比例均同步升高。此外,在结直肠癌组中,8例(15.7%)患者观察到H.pylori阳性表达,表现为模糊的颗粒状或粗杆状黏膜染色图形;而在对照组的结直肠组织中H.pylori未见表达。结论用免疫组化的方法可以证明H.pylori存在于结直肠癌组织中,尤其是血清H.pylori阳性并高胃泌素血症的患者;H.pylori感染可能诱导高胃泌素血症并与结直肠癌的形成有关。

Objective To investigate the correlation of Helicobacter(H.) pylori infection and hypergastrinemia with the pathogenesis of colorectal carcinomas as well as the expression of H.pylori in colorectal carcinomas.Methods Fasting serum samples from 51 patients with colorectal carcinomas and 43 demographically matched colonoscopy-negative controls were assayed for anti-H.pylori IgG using an enzyme-linked immunosorbent assay and serum gastrin levels by an radioimmunoassay,respectively.Furthermore,biopsy stains were immunohistochemically treated with anti-H.pylori antibodies in controls and colorectal cancer patients.H.pylori staining in the gastric mucosa was used as the control for the immunohistochemical method.Results The prevalence of H.pylori seropositivity and serum gastrin level were significantly higher in patients with colorectal carcinomas than in the controls(P<0.05).Moreover,H.pylori seropositivity was significantly higher than in patients with distal colon or rectal carcinomas than in those with proximal colon carcinoma(P<0.05).The proportion of hypergastrinemia patients was higher than that of patients with distal colon carcinoma(77.8% vs.37.5%,80.0% vs.37.5%,P<0.05).There was also an increased trend towards a worse Dukes staging.Positive expression of H.pylori was found in 15.7% of colorectal carcinoma patients and showed an equivocal and dot-like granular staining pattern compared to the controls.However,the controls did not show H.pylori expression in colorectal tissues.Conclusion With immunohistochemical method,we were able to determine H.pylori expression in patients with colorectal carcinomas,especially those with seropositivity of H.pylori and hypergastrinemia.Therefore,H.pylori infection may induce hypergastrinemia and be correlated with the pathogenesis of colorectal carcinomas.