胃癌高、低发区幽门螺杆菌感染人群中儿童抗CagA抗体及组织病理学的比较

Seroprevalence of Antibody to CagA and Histopathological Features of Gastric Mucosa in Children Infected with Helicobacter pylori China

明确我国胃癌高、低发区普通人群中幽门螺杆菌（Ｈｐ）感染儿童抗ＣａｇＡ及其他Ｈｐ特异性抗原抗体的差异。方法：采用Ｈｅｌｉｃｏ ｂｌｏｔ ２．０系统检测胃癌高发区（陕西省安塞县）和低发区（广东省从化县）年龄、性别匹配的Ｈｐ阳性、无症状儿童血清标本各３０例，并对两地儿童胃窦、胃体粘膜的组织学表现进行比较。结果：安塞县ＨＰ感染儿童血清抗ＣａｇＡ（１１６ｋＤａ）、ＶａｃＡ（８９ｋＤａ）、３５ｋＤａ、３０ｋＤａ、２６．５ｋＤａ和１９．５ｋＤａ抗体阳性率分别为９０％、３０％、９０％、１００％、 １００％和 ５６．６７％，从化县分别为９６．６７％、３００、８３．３３％、８６．６７％、８６．６７％和 ４３．３３％，两者比较无显著差异（Ｐ＞０．０５）。两地儿童胃粘膜慢性炎症、活动性炎症发生率均无统计学差异（Ｐ＞０．０５），但萎缩及淋巴滤泡形成在胃癌高发区有增多的趋势。结论：我国胃癌高、低发区普通人群从儿童期开始感染的Ｈｐ绝大数为抗ＣａｇＡ抗体阳性Ｈｐ，ｃａｇＡ基因不能作为我国胃癌危险性的预测指标。

Background/Aims: To study the seroprevalence of antibody to CagA in Helicobacter pylon (HP) infected children from the areas with high and low gastric cancer (GC) prevalence as to determine if CagA is a predictive marker of GC in China. Methods: Thirty of sex and age matched asymptomatic children were selected from children population of Anse county (high GC prevalence) and Conghua county (low GC prevalence), respectively. Serum antibodies to specific antigens of Hp were detected using Helico blot 2.0 Western blot system, and histopathological features of the gastric biopsy samples from the antrum and body of the stomach were assessed by the Sydney System. Results: There was no significant difference of antibodies to Hp specific antigens, including CagA, VacA, 35kDa, 30kDa, 26.5kDa and 19.5kDa between the children from the two areas (P>0.05). No difference was found in incidence between chronic and acute gastritis, but there was a trend of increasing rates of atrophy and lymphocytic follicle in Anse area. Conclusions: The seroprevalence of antibody to CagA is very com- mon in Hp-positive children, cagA gene couldn't be as a predictive marker of GC in China.