幽门螺杆菌感染与胃癌部位组织类型的关系

Relationship between Hp infection and the locations and histological types of gastric carcinoma

目的探讨幽门螺杆菌（Ｈｐ）感染与胃癌部位及组织类型的关系．方法胃镜及病理证实的胃癌７３例，男女之比为２０４∶１，平均年龄为５６０岁．其他肿瘤患者７３例（食管癌２２例；结直肠癌１９例；肺癌２１例；乳腺癌１１例），男女之比为１７０∶１，平均年龄为５５６岁，进行１∶１病例一对照研究，采用间接ＥＬＩＳＡ法检测血清抗ＨｐＩｇＧ抗体水平，将Ｈｐ抗体分为３个等级．结果胃癌组Ｈｐ感染率为５８９％，平均抗体水平为２２９±０８５（ｘ±ｓ），显著高于对照组的感染率４２５％（Ｐ＜００５）和平均抗体水平１８４±０６５（Ｐ＜００１）．Ｈｐ感染率在对照组的分布情况为食管癌４０９％，结直肠癌４７４％，肺癌３８１％，乳腺癌４５５％．胃癌组与对照组相比，机会比值呈线性趋势（Ｐ＝０００５４６０）．Ｈｐ阳性率在非贲门部胃腺癌为７４４％，明显高于贲门部腺癌４０７％（Ｐ＜００５）．结论Ｈｐ感染与胃癌有关，特别与非贲门部腺癌关系密切．胃癌的危险性随抗ＨｐＩｇＧ抗体滴度升高而升高．

AIM To investigate the relationship between Helicobacter pylori (Hp) infection, gastric carcinoma and its location and histological type. METHODS Seventy three patients with gastric carcinoma, with a ratio of male to female of 2 04∶1, mean age of 56 0 years, were confirmed by pathology and gastroscopy. Seventy three with other kinds of tumors (22 esophagus cancer, 19 rectocolonic cancer, 21 lung carcinoma, 11 breast cancer), the male to female ratia of 1 70∶1, the mean age 55 6 years, were studied with 1∶1 case matched controls. Indirect ELISA method was used to detect Hp IgG antibody in serum. Hp antibody was classified into three grades. RESULTS The positive rate of Hp infection and mean level of Hp IgG antibody were 58 9% and 2 29±0 85 ( ±s ) in gastric cancer group, which was significantly higher than that of the control group (42 5% and 1 84%±0 65, P <0 05 and P <0 01). The value of odds ratio (OR) of gastric carcinoma group has a linear tendency when it was compared with control group ( P =0 005460). Hp positive rate in non cardial gastric carcinoma was significantly higher than that of cardia adenocarcinoma (74 4% vs 40 7%, P <0 01). Positive rates of Hp infection in the control group were: esophagus cancer, 40 9%; rectocolonic cancer, 47 4%; lung carcinoma, 38 1%; and breast carcinoma, 45 5%. CONCLUSION Infection with Hp is associated with gastric carcinoma, and is strongly associated with non cardial adenocarcinoma. As the level of Hp IgG antibody increased, there was a progressive increase in the risk of gastric carcinoma.