胃癌前病变患者口腔中龋病及牙周病主要致病菌的分布研究

The main pathogens of dental caries and periodontal disease in patients with gastric precancerous lesion

目的本研究旨在评价和分析胃癌前病变患者口腔中龋病和牙周病主要致病菌的分布,探索胃癌患者口腔感染性疾病主要致病菌与健康人群的差异,为口腔疾病与胃癌的相关性的机制研究提供线索。方法按病理诊断结果,将研究对象分为胃癌前病变组和对照组。提取唾液和牙菌斑样本DNA,进行实时定量PCR,所得数据用χ2检验比较不同细菌的分布情况,Mann-Whitney非参数检验比较不同组别细菌的DNA水平的差异。结果病例和对照组的唾液中的变异链球菌(Streptococcus mutans,Sm)和远缘链球菌(Streptococcus sobrinus,Sb)2种龋病相关主要致病菌,无论是检出率还是DNA水平均没有显著性差异。病例和对照组的唾液和牙菌斑中牙周病主要病原菌牙密螺旋体(Treponema denticola,Td)、伴放线放线杆菌(Actinobacillus actinomycetemcomitans,Aa)和福赛斯坦纳菌(Tannerella forsythensis,Tf)的DNA水平均高于对照组,Aa在两组中差异具有统计学意义(P<0.05)。唾液样本中Pg的DNA水平在两组间则颇为相近,病例组稍低于对照组。牙菌斑样本中的Pg则是病例组略高于对照组,差异不具有统计学意义。结论胃癌前病变患者口腔中被测的龋病主要致病菌与未见差异,而牙周主要致病菌的含量与健康对照人群有所不同。伴放线放线杆菌可能在胃癌与牙周病相关性中发挥作用。

Objective To evaluate and analyze the distribution of major pathogens related to dental caries and periodontal disease in patients with gastric precancerous lesion. Methods This study consisted of 98 individuals who received the upper gastrointestinal endoscopy examination. The subjects were divided into gastric precancerous group and control group. Bacterial samples were taken from all 98 subjects at the time of dental examination. After extracting DNA from saliva and plaque samples, real-time quantitative PCR was performed. The data were statistically analyzed. Results There was no significant difference in the detection rate and DNA level of the two main cariogenie pathogens of S. mutans （Sin） and S. sobrinus （Sb） in the saliva of patients and control groups. The DNA levels of the major periodontal pathogens such as T. denticola （ Td） , A. actinomycetemcomitans （ Aa） and T. forsythensis （Tf） in the saliva and plaque were higher than those in the control group. Especially Aa in the patients was significantly higher than the control group. The DNA level of P. gingivalis （Pg） in the saliva samples was similar between the two groups. Pg in the plaque samples was slightly higher in the patient group than in the control group, but the difference was not significant. Conclusion The levels of tested major periodontal pathogens in the oral cavity of patients with gastric precancerous lesion were different from those of healthy control subjects. A. actinomycetemcomitans may play a role in the relationship between gastric cancer and periodontal disease.