食管癌患者检测幽门螺杆菌的临床意义

Relationship between helicobacter pylori infection and esophageal cancer with metastasis

目的:探讨幽门螺杆菌(Hp)检测在食管癌术后复发中的价值。方法:2002年-2004年食管鳞癌患者80例(胸上段癌4例,胸中段癌56例,胸下段癌20例),作为实验组。正常人和胃十二指肠良性疾病患者80例作为对照组。其中实验组再分为抗癌+抗Hp治疗及单纯抗癌治疗组各40例。快速尿素酶试验及Warthin-Strarry银染色检测Hp,ELISA法检测血中抗HpIgG抗体。结果:对照组食管Hp的感染率为21.25%(17/80),实验组为92.5%(74/80),两组差异显著(P<0.05)。对照组血清抗HpIgG抗体阳性率为10%(8/80),实验组为55%(44/80),差异有显著性(P<0.05)。食管癌切除术后抗癌+抗Hp治疗组Hp的感染率为12.5%(5/40),单纯抗癌治疗组达90%(36/40)(P<0.05),随访3年抗癌+抗Hp治疗组食管癌复发率为22.5%(9/40),单纯抗癌治疗组食管癌复发率为42.5%(17/40)(P<0.05)。结论:幽门螺杆菌感染与食管癌复关系密切。

Objective： To study the relationship between helicobacter pylori infection and esophageal cancer. Methods： Eighty cases with esophageal cancer were studied and 80 healthy subjects as control. HP of esophageal tissue was detected by both Warthin - starry method and RUT. Anti - HplgG was measured by ELISA. Results ： Hp infection rate was 21.25% in the control group,while it was as high as 92.5% in cancer pat ients（P 〈0.05）. The positive rate of HplgG was 10% ,but it was as high as 55% in the study group（P 〈0.05）. The metastasis rate in anti - Hp group was significantly lower than that in without anti - Hp group （ P 〈 0. 05 ）. Conclusion： Hp infection of esophagus is associated with the incidence and development of esophageal cancer.