Hp cagA、vacA s1m2基因与萎缩性胃炎疾病诊断的相关性研究

Association of Hp cagA and vacA s1m2 genes with the diagnosis of atrophic gastritis

目的研究幽门螺旋杆菌cagA、vacA s1m2基因与萎缩性胃炎疾病诊断的相关性。方法回顾性选取南京梅山医院2017年2月至2018年2月期间内进行胃镜检查的100例胃炎患者为研究对象,其中浅表性胃炎37例,萎缩性胃炎35例,胃溃疡28例。PCR检测三组患者的胃黏膜组织的幽门螺旋杆菌cagA、vacA s1m2基因表达,分析三组患者的cagA、vacA s1m2基因与萎缩性胃炎疾病诊断的相关性。使用ROC曲线,分别对cagA、vacA s1m2单独检测和联合检测,分析其诊断灵敏度之间的差异。结果通过对患者的cagA、vacA s1m2基因分析,三组患者的cagA、vacA s1m2基因阳性情况表达之间的差异存在统计学意义(P<0.05),其中,cagA基因表达率从高到低依次为胃溃疡、萎缩性胃炎以及浅表性胃炎,而vacA s1m2基因表达率从高到低依次为萎缩性胃炎、浅表性胃炎、胃溃疡。浅表性胃炎、萎缩性胃炎以及胃溃疡患者的诊断与幽门螺旋杆菌的cagA、vacA s1m2的基因相对表达量呈现正相关,联合检测诊断效能显著高于单独检测,差异存在统计学意义(P<0.05)。结论幽门螺旋杆菌的诊断与患者的cagA基因表达以及vacA s1m2基因表达呈现显著相关性,建议在临床诊断中进行推广。

Objective To discuss the association of Hp cagA and vacA s1m2 genes with the diagnosis of atrophic gastritis.Methods 100 patients with gastritis underwent gastroscopy from February 2017 to February 2018 were selected as the research subjects,including 37 patients with superficial gastritis,35 patients with atrophic gastritis and 28 patients with gastric ulcer.The correlation between cagA,vacA s1m2 genes and the diagnosis of atrophic gastritis was analyzed by detecting Helicobacter pylori in gastric mucosa tissues of three groups.ROC curve was performed to discuss and analyze the diagnostic sensitivity of cagA and vacA s1m2 separately and jointly.Results Through the analysis of cagA and vacA s1m2 genes,there were significant differences in the expression of cagA and vacA s1m2 genes among the three groups(P<0.05).The expression rates of cagA genes from high to low were gastric ulcer,atrophic gastritis and superficial gastritis,while the expression rates of vacA s1m2 genes from high to low were atrophic gastritis,superficial gastritis and gastric ulcer.Superficial gastritis,atrophic gastritis and gastric ulcer were significantly correlated with cagA and vacA s1m2 genes of Helicobacter pylori respectively,and the combined detection of West was significantly higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion The diagnosis of Helicobacter pylori is significantly correlated with the expression of cagA gene and vacA s1m2 gene.It is suggested that the diagnosis of Helicobacter pylori should be popularized in clinical diagnosis.