幽门螺杆菌感染对胃粘膜上皮细胞增殖的影响

24Effect of Helicobacter Pylon infection on Gastric Epithelial Cell Proliferation

目的：观察幽门螺杆菌（Ｈ． ｐｙｌｏｒｉ）感染者，特别是ｖａｃＡ ｓｌａ型菌株感染者胃粘膜上皮细胞的增殖情况。方法：取８４例慢性浅表性胃炎（ＣＳＧ）和１６例十二指肠溃疡（ＤＵ）患者的胃窦粘膜标本检测Ｈ． Ｐｙｌｏｒｉ，用溴脱氧尿苷掺入免疫组化法标记Ｓ期细胞并计算增殖标记指数（ＬＩ），用聚合酶链反应（ＰＣＲ）检测ｖａｃＡ ｓｌａ基因。结果： Ｈ．ｐｙｌｏｒｉ阳性患者的胃粘膜上皮细胞增殖ＬＩ为６．１４％±１．２１％，显著高于Ｈ．Ｐｙｌｏｒｉ阴性者（２．４３％±０．６１％，Ｐ＜０．００１）。ｖａｃＡｓｌａ阳性者的ＬＩ为８．００％±１．４６％，显著高于ｖａｃＡ ｓｌａ阴性者（４．５１％±０．８６％，Ｐ＜０．０５）和Ｈ．ｐｙｌｏｒｉ阴性者（Ｐ＜０．００１）。Ｈ．ｐｙｌｏｒｉ感染、胃粘膜上皮细胞增殖ＬＩ与胃粘膜炎症程度三者高度相关，而炎症程度与ｖａｃＡ类型无关。结论： Ｈ． ｐｙｌｏｒｉ感染者的胃粘膜上皮细胞增殖ＬＩ明显高于Ｈ． ｐｙｌｏｒｉ阴性者； ｖａｃＡ ｓｌａ型Ｈ． ｐｙｌｏｒｉ菌株和炎症程度是胃粘膜上皮细胞增殖的独立影响因素。

Background/Aims: To investigate whether Helicobacter pylon (H. pylon) infection, especially the strains with vacA sla accelerates gastric epithelial cell proliferation. Methods: Gastric biopsy specimens were taken from 84 patients with chronic superficial gastritis (CSG) and 16 duodenal ulcer (DU). H. Pylon was identified and gastric epithelial proliferation labelling indices (LI) were scored by bromodeoxyuridine (BrdU) immunohistochemistry. Analysis of H. Pylon genomic DNA by polymerase chain reaction (PCR) was performed to determine the vacA genotype. Results: The patients with H. pylon infection had higher LI (6.14% ± 1.21%) than noninfected patients (2.43% ±0.61%, P< 0.001). Patients harbouring vacA sla strains had significantly higher LI (8.00%±1.46%) than patients with non-vacA sla strains (4.51% ±0.86%, P<0.05) and noninfected patients (P< 0.001). The level of LI was also associated with the degree of inflammation. But no relationship was found between the degree of inflammation and vacA genotype. Conclusions: H. pylon-positive patients have higher proliferative LI of gastric mucosal epithelial cells than H. pylon-negative patients; vacA sla strain and the degree of inflammation are independent affecting factors of gastric epithelial cell proliferation.