胃癌患者幽门螺杆菌L型感染的临床研究

Clinical investigation of L-form from Helicobacter pylori in gastric cancer patients

目的探讨胃癌与幽门螺杆菌L型(Hp-L)感染的关系。方法取186例胃癌患者胃窦和胃体粘膜组织常规切片后经革兰氏染色和免疫组化染色镜检Hp-L型细菌。结果Hp-L型检出率为56.45%(105/186),革兰染色和免疫组化染色法检出率分别为60.22%(112/186)和58.60%(109/186),差异无显著性(χ2=0.1,P>0.05),男女患者阳性率依次为69.16%(74/107)和39.24%(31/79),前者明显高于后者(χ2=16.55,P<0.01)。30岁以下、30岁￣、40岁￣、50岁￣患者Hp-L型阳性率分别为33.33%(4/12)、41.38%(12/29)、52.73%(29/55)、66.67%(60/90),差异显著(χ2=9.39,P<0.05)。Hp-L型阳性率在肠型胃癌患者中为75.42%(89/118),明显高于弥漫型患者为23.53%(χ2=47.26,P<0.01);胃窦部胃癌患者(64.71%)高于贲门部患者(41.79%)。结论胃癌患者Hp-L型感染率较高,且男性高于女性。Hp-L型检出率随年龄增长而增高,且主要作用于胃窦部,是引起肠型胃癌的重要致病因子之一。

Objective To study the relationship between helicobacter pylori L-form （Hp-L） infection and gastric cancer. Methods Gastric mucosa was taken from 186 patients with gastric cancer to detect Hp-L by Gram staining and immunohistochemistry staining. Results The detectable rates of Hp-L was 56.45%（105/186）. And it was 58.60% （109/186） by immunohistochemistry staining and 60.22% by Gram staining respectively. There was no statistics significant difference between this two methods （P〉0.05）.To be more exact, the detectable rates of Hp-L in male and female patients were 69.16 % （74/107） and 39.24% （31/79） respectively, statistics found significant difference between them （x^2=16.55, P〈0.01）. Furthermore, the detectable rates of Hp-L was significant difference between patients aged 30 years- and 40 years- （P〈0.05）. In patients with intestinal and diffuse type gastric cancers, the infective rate of Hp-L was 75.42% （89/118） and 23.53% （16/68）, respectively （P〈 0.01）. In patients with gastric antral and cardiac cancers, the detectable rate of Hp-L was 64.71% （79/119） and 41.79%（28/67）, respectively （P〈0.05）. Conclusion L-forms variation often occurs in patients with gastric cancer and is commonly found in male patients and associates with ages. The L-forms variation may be an important factor caused the intestinal gastric cancer, and more act in gastric antrum.