幽门螺杆菌感染情况及其抗体与胃癌前疾病、胃癌的相关性研究

Study on association of Helicobacter pylori infection with gastric precancerous diseases and gastric cancer

目的研究宁夏惠农区回、汉族人群幽门螺杆菌(Helicobacter pylori,Hp)感染的情况及其与胃癌前病变、胃癌的相关性。方法选择宁夏惠农区回、汉族383例,其中正常对照组99例(回族45例,汉族54例)、慢性萎缩性胃炎组97例(回族45例,汉族52例)、胃溃疡组75例(回族35例,汉族40例)和非贲门胃癌组112例(回族50例,汉族62例)。采用免疫印迹法检测血清Hp抗体、细胞毒素相关基因蛋白(CagA)、空泡毒素(VacA)、尿素酶B(UreB)、尿素酶A(UreA)。结果①回、汉族正常对照组Hp阳性率分别为68.9%和70.3%,差异无统计学意义(P>0.05);回、汉族Hp阳性率在胃溃疡和非贲门胃癌组中高于正常对照组,差异有统计学意义(P<0.05);②回、汉族CagA抗体阳性的Hp在慢性萎缩性胃炎、胃溃疡和非贲门胃癌组中高于正常对照组,差异有统计学意义(P<0.05)。CagA+VacA、VacA、UreA和UreB抗体阳性率在对照组、慢性萎缩性胃炎、胃溃疡和胃癌中差异均无统计学意义(P>0.05)。结论①宁夏惠农区回、汉族正常人群Hp感染率高,回、汉族之间Hp感染差异无统计学意义。②宁夏惠农区回、汉族人群胃癌前疾病及胃癌高发与CagA抗体阳性Hp感染率高密切相关,表明Hp致病因子中毒素CagA发挥着主要作用。

Objective To study on association of Helicobacter pylori infection with chronic gastritis, gastric ulcer and gastric cancer in Hui and Han nationalities of Huinong area. Methods Hp antibodies （ CagA, VacA, UreB and UreA） in serum were measured by immunoblotting. In 383 cases with gastric precancerous diseases, gastric cancer and healthy controls, among 97 cases chronic gastri- tis （45 Hui nationalities,52 Han nationalities）, 75 cases gastric ulcer （35 Hui nationalities,40 Han nationalities）, 112 cases gastric cancer （50 Hui nationalities, 62 Han nationalities） and 99 healthy controls （45 Hui nationalities, 54 Han nationalities）. Results Posi- tive rates of Hp were 68.9% and 70.3% in healthy controls of Hui and Han nationalities, respectively. Positive rates of Hp in gastric ulcer and gastric cancer were higher than that in healthy controls in Hui and Han nationalities, there were difference by statistical com- parison （P 〈 0.05）. In the cases with chronic gastritis, peptic ulcer and noncardia gastric cancer, positive rates of CagA Hp were sig- nificantly higher than that in healthy controls, there were difference by statistical comparison （P 〈 0.05 ）. Positive rates of VacA, Urea and UreB had not difference by statistical comparison （ P 〉 O. 05 ）. Conclusion Positive rates of Hp in healthy controls are high in Hui and Han nationalities of Huinong area, but there are not significant difference between Hui and Han nationalities. Gastric precancerous diseases and gastric cancer are related to CagA Hp positive infection in Hui and Han nationalities of Huinong area, to presume CagA played a main role in Helicobacter pylori infection.