胃癌高发区早期筛查人群HP感染与病理结果的相关性研究

Study on Correlation between the HP Infection and Pathological Results of Early Screen Group in the High Incidence Area of Gastric Cancer

目的探讨胃癌高发区早期筛查人群HP感染与病理结果的相关性。方法对2014年8月—2016年9月5290名扬中市兴隆、油坊两镇早筛人群进行C_(13)-UBT检测,同时按筛查路径做胃镜及病理检查,按HP阳性与阴性分组,分别观察两组的病理结果,并分析之间的相关性。结果 5 290名村民接受筛查,其中C_(13)-UBT阳性者3 397例(占64.22%),阴性者1 893例(占35.78%);HP阳性组,检出重度胃炎3 264例(占96.08%)、肠上皮化生1 796例(占52.87%)、胃粘膜上皮内瘤变13例(占0.38%)、胃分化性腺癌8例(占0.23%);HP阴性组,检出重度胃炎768例(占40.57%),肠上皮化生232例(占12.25%),胃粘膜上皮内瘤变9例(占0.47%),胃分化性腺癌3例(占0.15%)。两组之间比较,Hp感染与重度胃炎、肠上皮化生有明显相关性,与胃粘膜上皮内瘤变、胃分化性腺癌相关性较低(RR=2.37、4.75、0.8、1.49)。结论 HP感染与胃腺癌的启动阶段,即胃炎-萎缩-肠化相关,当病理发展到胃粘膜肠化阶段时,能否引发胃粘膜上皮内瘤变或胃腺癌,则是内外多因素长期反复作用的结果,在胃粘膜肠上皮化生发生前根除HP,阻断胃腺癌发生的基础环节无疑是正确的。

Objective To study the correlation between the HP infection and pathological results of early screen group in the high incidence area of gastric cancer.Methods 5 290 cases of patients in xinglong town and youfang town in Yangzhong from August 2014 to September 2016 were for C13-UBT test,at the same time,the patients were for gastroscopy and pathological examination according to the screening route,and the patients were divided into groups according to the negative and positive HP,and the pathological results of the two groups were respectively observed,and the correlation was analyzed.Results 5 290 villagers received the screening,including 3 397 cases with positive C13-UBT,accounting for 64.22%,1 893 cases with negative C13-UBT,accounting for 35.78%;in the HP positive group,3 264 cases of patients with severe gastritis were tested,accounting for 96.08%,1 796 cases with intestinal metaplasia,accounting for 52.87%,13 cases with intraepithelial neoplasia of gastric mucosa,accounting for 0.38%,8 cases with gastric differentiated adenocarcinoma,accounting for 0.23%;in the negative HP group,768 cases of patients with severe gastritis,accounting for 40.57%,232 cases with intestinal metaplasia,accounting for 12.25%,9 cases with intraepithelial neoplasia of gastric mucosa,accounting for 0.47%,3 cases with gastric differentiated adenocarcinoma,accounting for 0.15%,and the（RR=2.37,4.75,0.8,1.49）.Conclusion The HP infection is the initiating stage of gastric adenocarcinoma,namely,correlated with Gastritis atrophy-intestinal metaplasia,when the pathology develops into the intestinal metaplasia stage of gastric mucosa,whether the intraepithelial neoplasia of gastric mucosa or gastric adenocarcinoma can be caused is the long-term and repeated result of internal and external factors,and eradication of HP before the occurrence of intestinal metaplasia in gastric mucosa and blocking the basic link of occurrence of gastric adenocarcinoma is undoubtedly accurate.