河南食管和贲门癌高发区人群幽门螺杆菌感染与食管、贲门和胃窦粘膜病变的关系

Comparison of helicobacter pylori (Hp) infection in the cardia and pylori parts of the stomach from symptom-free subjects at high-incidence area for esophageal and gastric cardia cancer in Henan

目的 :了解幽门螺杆菌 (Helicobacterpylori,Hp)在河南食管和贲门癌高发区无症状人群贲门与胃窦部粘膜感染及与贲门和食管病变的关系。方法 :食管癌高发区无症状居民 184例 ,分别采用改良Giemsa染色法检测粘膜活检组织中Hp感染和ELISA法检测血中Hp抗体。 结果 :Giemsa染色结果表明贲门Hp感染率明显低于胃窦部 (34%vs 6 2 % )。血清Hp抗体阳性率为 6 5 % ,与组织中Hp感染率较为一致 ,慢性浅表性贲门炎组织Hp感染率明显高于正常贲门上皮 (6 2 %vs 13% ) ,胃窦部与上述结果相似。特别值得指出的是 ,10例食管粘膜上皮为间变的患者 ,贲门Hp均为阴性。 结论 :结果提示 ,食管和贲门癌高发区无症状人群Hp感染率很高 ,并与贲门和胃窦慢性炎症有关 。

Aim: To characterize the infection of helicobacter pylori (Hp) in the gastric cardia and pylori from the symptom free subjects at the high incidence area for esophageal and gastric cardia cancers in Henan, Northern China, and correlate the infection of Hp with the lesions of gastric cardia and esophagus.Methods: Modified Giemsa staining was used for detection of Hp in the gastric cardia and pyloric biopsies; ELISA method was used to detect the level of anti Hp antibodies in blood from the same population. Result: Giemsa staining showed that the infection rate of Hp was much lower in gastric cardia than that in gastric pylori (34% vs 62%). The positive rate for anti Hp antibody was 65%, which was consistent with the detection rate of Hp in the tissue. Infection rate for Hp increased from normal gastric cardia tissue to chronic superficial gastritis (13% vs 62%). The similar results were observed in gastric pyloria. It was worth noting that in 10 cases with esophageal dysplasia, Hp was always negative in the gastric cardia.Conclusion: The present results indicate that there is a high incidence rate for Hp infection in symptom free subjects at high incidence area for esophageal and gastric cardia cancers. Hp infection is correlated with esophageal lesions at gastric cardia and pylori. Hp infection in gastric cardia may have potential protective effects on esophageal epithelium.