人乳头瘤病毒16幽门螺杆菌细胞毒素相关蛋白A和尿素酶基因A基因型感染与胃癌的相关性分析

Analysis of relationship of the infection of human papillomavirus 16 H.pylori cagA gene and ureA gene in gastric carcinogenesis

目的探讨人乳头瘤病毒16(HPV16),幽门螺杆菌细胞毒素相关蛋白A(cagA)、尿素酶基因A(ureA)在胃癌发生发展中的作用及三者关系。方法以病理活检确诊的胃癌患者为试验组(92例),癌前病变(包括肠化生、萎缩性胃炎、非典型增生等)患者对照组(86例),胃镜下取胃癌组织,采用聚合酶链反应(PCR)体外扩增方法,检测胃癌组织及癌前病变组织中HPV16-DNA,用快速尿素酶试验检测幽门螺杆菌,阳性患者做PCR体外扩增,并用PCR法进行幽门螺杆菌cagA和ureA基因检测,进行基因分型。结果①对照组HPV16,阳性率为4.6%(4/86);试验组HPV16,阳性率为21.7%(20/92),差异有统计学意义(P<0.05)。HPV16 aGC和HPV16 nGC在年龄、病理类型方面差异无统计学意义(P>0.05);在性别方面差异有统计学意义,男性HPV16阳性率低于女性(P<0.05)。②等级统计分析表明,HPV16感染与慢性胃炎→萎缩→肠化生→高中低分化胃癌演变过程中呈正相关(r=0.254 65,P=0.016)。③试验组幽门螺杆菌感染率60.9%(56/92),对照组幽门螺杆菌感染率37.2%(32/86),试验组与对照组比较差异有统计学意义(P<0.05)。④慢性浅表性胃炎、萎缩、肠化生、胃癌各组织中幽门螺杆菌与cagA和ureA表达均呈正相关(P<0.01)。⑤幽门螺杆菌、cagA、ureA表达在性别、年龄差异无统计学意义(P>0.05),但在病理类型方面幽门螺杆菌、cagA、ureA表达差异有统计学意义(P<0.01.)。⑥HPV16感染与幽门螺杆菌cagA呈正相关(r=0.231 99,P=0.028 7),与幽门螺杆菌ureA无相关性(r=0.025 95,P=0.809 4)。结论①HPV16感染与胃癌的发生发展有一定相关性,HPV16感染与慢性胃炎→萎缩→肠化生→胃癌演变过程中呈正相关。但HPV16感染与胃癌患者年龄、病理类型、无明显相关性。②幽门螺杆菌感染与胃癌的发生密切相关,幽门螺杆菌感染与胃癌的临床病理类型相关,但幽门螺杆菌感染与胃癌患者性别、年龄无明显相关性。③胃癌发生中HPV16感染和cagA的表达呈正相关,与ureA无明显相关性。

Objective To investigate the human papillomavirus 16 （HPV16）, H.pylori cagA gene, ureA gene in gastric carcinogenesis and the development of relations between the role. Methods Gastric cancer patients for the experimental group （92 cases）, precancerous lesions （including intestinal metaplasia, atrophic gastritis, atypical hyper- plasia） patients in control group （86 cases）, were confirmed by biopsy. Endoscopic gastric tissue taken, using polymerase chain reaction （PCR） In vitro amplification methods to detect gastric cancer and precancerous lesions of HPV16-DNA, with the rapid urease test for detection of H.pylori, positive patients do PCR in vitro amplification by PCR method H.pylori cagA and ureA genetic testing, genotyping. Results ① Control group, four cases, the positive rate was 4.6% （4/86）; experimental group of 20 cases, the positive rate was 21.7%（20/92）. Differences between experimental and control groups were statistically significant （P〈0.05）. HPV16 aGC and HPV16 nGC in age, the difference of pathological type was not statistically significant （P〉0.05）; the difference of gender was statistically significant, male HPV16-positive rate of less than females （P〈0.05）. ② Level statistical analysis showed that HPV16 infection and chronic gastritis →atrophy →intestinal metaplasia Thigh poorly differentiated gastric evolution was positively correlated （r=0.254 65, P=0.016）. ③ H.pylori infection rate of the experimental group was 60.9%（56/92）, H.pylori infection rate was 37.2% in the control group （32/86）, the experimental group and the control group was significantly different （P〈0.05）. ④Chronic superficial gastritis, atrophy, intestinal metaplasia, gastric H.pylori in organizations with cagA and urea in a positive correlation （P〈0.01）. ⑤ H.pylori cagA, ureA positive and negative in terms of gender, age difference was not statistically significant （P〉0.05）, but H.pylori , cagA, ureA-positive and-negative were significantly different in the pathology aspects （P〈0.01）. ⑥ Correlation analysis showed that HPV16 infection with H.pylori cagA positive was correlation （P=0.028 7, r=0.231 99）, with H.pylori ureA was no correlation （P=0.809 4, r=0.025 95）. Conclusions ① HPV16 infection and development of gastric cancer have a certain relevance, HPV16 infection and chronic gastritis→atrophy→intestinal metaplasia→gastric evolution was positively correlated. But the HPV16 infection and gastric cancer patient age, histological type, no significant correlation. ② H.pylori infection and gastric cancer is closely related to, H.pylori infection and gastric cancerpathology related to, but H.pylori infection and gastric cancer patient gender, age, no significant correlation. ③ gastric cancer HPV 16 infection and cagA expression is positively correlated with ureA, and it is no significant correlation.