幽门螺杆菌及其cagA因子与胃腺癌的关系

The relationship between Helicobacter pylori, its cagA factor and the gastric adenocarcinoma

目的 :探讨Hp与胃腺癌的相关性 ,特别是cagA因子与胃腺癌的相关性。 方法 :利用血抗Hp IgG、RUT、PCR Hp DNA 3种方法检测 2 70例病人耳垂血或胃粘膜活检组织中的Hp及其cagA基因。 结果 :Hp感染率为 6 8 5 2 % (无性别差异 ) ,cagA+ Hp感染率为 5 4 73% (男性 6 4 0 0 % >女性 41 94% ,P <0 0 5 )。cagA+ Hp致胃炎程度及活动性均较cagA-Hp及Hp 者高 (P <0 0 5 ) ;男性感染cagA+ Hp更易发展为CAG、IM (P <0 0 5 ) ;感染Hp者胃腺癌的分化程度低 ,且向周围浸润及淋巴结转移的能力强 (P <0 0 5 ) ,但与cagA因子无关 (P >0 0 5 ) ;非贲门腺癌患者血抗Hp IgG抗体阳性率为 76 32 % ,大于贲门癌 (5 2 90 % ) (P <0 0 5 )。 结论 :Hp感染与胃腺癌发生、发展相关 ;cagA因子可能为胃腺癌 ,特别是男性胃腺癌的致癌因子之一 。

Objective:To investigate the relationship between Helicobacter pylori (Hp), especially its cagA factor, and the gastric adenocarcinoma (GAC)Methods:The Hp in gastric biopsy specimens from 270 patients with chronic gastritis or GAC, were detected by PCR,the serum antiHpIgG detection and RUT while cagA gene expression was detected by PCRResults:The infection rate of Hp was 6852%without difference between sex, while of cagA+Hp strains infection it was 5473%(6400%in male patients, 4194%in female patients, P< 005)The inflammatory index and activity in gastricmucosa induced by cagA+Hp strains were higher than that induced by cagA-Hp strains or that without Hp infection (P< 005)The prevalence of chronic atrophic gastritis (CAG) or intestinal metaplasia(IM) was higher in the male patients infected with cagA+Hp strains than that infected with cagA-Hp or uninfected with Hp (P< 005)The GAC infected with Hp had lower differentiation, morenoncardiac adenocarcinomas, and higher invasive or lymph node metastatic abilities than that without Hp infection (P< 005), but not correlated with the cagA factor (P >005)Conclusions:The infection of Hp is correlated with the genesis of GAC, that influence the development of GAC via noncagA pathwaysThe cagA factor may be a carcinogenic factor of GAC, especially in the maleGAC, and may play a role in the early stage of gastric carcinogenesis