不同部位、分化和起源胃癌中H.pylori、CagA基因的探讨

Investigation of H.pylori and CagA genes in gastric cancer with different parts,differention and origin

目的通过检测不同部位和不同组织类型中胃癌组织中幽门螺杆菌(H.pylori)和细胞毒素相关基因(CagA基因),探讨H.pylori、CagA基因与胃癌的关系,以及H.pylori、CagA基因导致胃癌的可能机制。方法应用快速尿素酶试验和组织切片革兰染色及血清H.pylori CagA抗体检测胃癌患者H.pylori,应用PCR检测胃癌组织中H.pylori CagA基因。结果胃癌组织中随活检部位不同,H.pylori检出率也不同,以胃窦部检出率最高为76.9%,与胃体大弯侧、胃角和贲门相比差异均有非常显著性(P<0.005),胃体大弯侧、胃角与贲门相比差异均有非常显著性(P<0.005),胃底与贲门相比差异无显著性(P>0.05)。胃窦部癌的CagA检出率(85.6%)最高,与其他部位相比差异均有非常显著性(P<0.005),胃角胃癌CagA检出率显著高于胃体大弯侧和贲门胃癌(P<0.005)。高分化胃癌H.pylori检出率为73.1%,低分化胃癌H.pylori检出率为44.1%,二者相比差异均有非常显著性(P<0.01)。肠型胃癌H.pylori检出率为76.7%,弥漫型胃癌H.pylori检出率为33.3%,二者相比差异有显著性(P<0.05),高分化胃癌CagA检出率为26.3%,低分化胃癌CagA检出率为80.0%,二者相比差异均有非常显著性(P<0.01)。肠型胃癌CagA检出率为80.4%,弥漫型胃癌CagA检出率为57.1%,二者相比差异无显著性(P>0.05)。结论不同部位和不同组织类型中胃癌组织中H.pylori和CagA基因的表达存在一定差异性,对探讨胃癌的发生及胃癌的防治有一定的指导意义。

Objective To detect Helicobacter pylori（H.pylori） cytotoxic-associated gene A（CagA gene） in different parts and histological types of gastric cancer tissue and discuss the relationship between H.pylori,CagA gene and gastric cancer as well as the probable mechanism that may lead to oncogenesis in stomach.Method H.pylori was examined with rapid urease test,Gram staining and serum CagA antibodies;CagA gene of H.pylori in H.pylori-positive gastric cancer tissue was tested by polymerase chain reaction（PCR）.Result The positive rates of H.pylori in gastric cancer tissue varied along with differention of biopsy site.The positive rate of H.pylori in antrum was 76.9% at most,significantly different with those in greater curvature side of gastric body,angulus and cardia（P〈0.005）.The positive rates of H.pylori in grea-ter curvature side of gastric body and angulus were significantly different with that in cardia（P〈0.005）,but there was no significant difference between those in fundus and cardia（P〉 0.05）.The positive rate of CagA in antrum was the highest （85.6%）,significantly different with other parts of gastric cancer（P〈0.005）;On the other hand,the positive rate of CagA in angulus was significantly higher than those of greater curvature side of gastric body and cardia in gastric cancer（P〈0.005）.The positive rate of H.pylori of well-differentiated gastric cancer was 73.1%,while that of poorly differentiated gastric cancer was 44.1%;There were significant difference between the two groups（P〈0.01）.The positive rate of H.pylori in intestinal-type gastric cancer was 76.7%,while that in diffuse-type gastric cancer was 33.3%,and the difference was significant（P〈0.05）.The positive rate of CagA of well-differentiated gastric cancer was 26.3%,while that of poorly differentiated gastric cancer was 80.0%;there were significant difference between them（P〈0.01）.The positive rates of CagA of intestinal-type and diffuse-type gastric cancer were 80.4% and 57.1% respectively,with no significant difference statistically（P〉0.05）.Conclusion The expressions of H.pylori and CagA gene in different parts and histological types of gastric cancer tissue show a certain difference,which is of significance for exploring the occurrence,prevention and treatment of gastric cancer.