幽门螺杆菌感染和高胃泌素血症与结直肠癌的相关性研究

The association of Helicobacter pylori infection and hypergastrinemia with colorectal cancer

目的:探讨幽门螺杆菌(Helicobacter pylori)感染、高胃泌素血症和环氧合酶-2(cyclooxygenase-2,COX-2)与结直肠癌的相关性。方法:采用放射免疫分析法检测51例结直肠癌患者和43例非结直肠癌患者(对照组)血清中胃泌素的表达水平,ELISA法检测血清中抗幽门螺杆菌IgG的表达水平。给予结直肠癌患者口服塞来昔布6个月,分别于服药2、4和6个月时检测血清中胃泌素和抗幽门螺杆菌IgG的表达水平。结果:结直肠癌患者的幽门螺杆菌阳性率和血清胃泌素表达水平均明显高于对照组(P<0.05)。结直肠癌患者血清中胃泌素的表达水平与抗幽门螺杆菌IgG的表达量显著相关(r=0.662,P<0.001)。远端结肠与直肠癌患者幽门螺杆菌的阳性率显著高于近端结肠癌患者(P<0.05);同时,高胃泌素血症患者所占比率也明显高于近端结肠癌患者(P<0.05)。此外,随着Duke分期的升高,幽门螺杆菌阳性率与高胃泌素血症患者所占比率均同步升高。口服塞来昔布后,结直肠癌患者血清中幽门螺杆菌阳性率和血清胃泌素的表达水平均呈下降趋势,并且随着服药时间的延长进一步下降。结论:幽门螺杆菌感染诱导高胃泌素血症可能与结直肠癌的形成相关。选择性COX-2抑制剂塞来昔布可降低幽门螺杆菌阳性率和血清胃泌素的表达水平。

Objective：To investigate the correlation of Helicobacter pylori infection,hypergastrinemia,and cyclooxygenase-2（COX-2） with colorectal carcinomas.Methods：The serum gastrin levels were determined in 51 patients with colorectal carcinomas and 43 demographically matched colonoscopy-negative controls by radioimmunoassay.The Helicobacter pylori IgG was detected by enzyme-linked immunosorbent assay（ELISA）.Fifty one patients with colorectal carcinomas were given celecoxib orally for 6 months.The gastrin and Helicobacter pylori IgG were detected at 2,4,and 6 months after drug therapy.Results：The positivity of Helicobacter pylori and serum gastrin levels were significantly higher in patients with colorectal carcinomas as compared with controls（72.5% vs 9.30%,P 〈0.05;125.22 pg/mL vs 77.65 pg/mL,P〈0.05）.A significant correlation was found between the level of Helicobacter pylori IgG and the level of gastrin（r=0.662,P0.001）.The positivity of Helicobacter pylori was higher in distal colorectal cancer than that in proximal colon cancer（P〈0.05）.The percentage of patients with higher gastrin levels was statistically higher in patients with distal colorectal cancer than those with proximal colon cancer（P〈0.05）.The positivity of Helicobacter pylori and the percentage of patients with higher gastrin levels increased with the increase in Duke staging.After oral administration of celecoxib,the positivity of Helicobacter pylori and the percentage of patients with higher gastrin levels decreased in a time-dependent manner.Conclusion：Hypergastrinemia induced by Helicobacter pylori infection may be related with tumorigenesis of colorectal carcinoma.COX-2 inhibitor celecoxib obviously decreased Helicobacter pylori seropositivity and gastrin levels.