不同毒素分型的幽门螺杆菌感染与非贲门胃癌发病风险的相关性研究

Correlation between Helicobacter pylori infection with different toxin types and the risk for non-cardia gastric cancer

目的探讨不同毒素分型的幽门螺杆菌(Hp)感染与非贲门胃癌发病风险的相关性研究。方法回顾性分析Hp感染的胃黏膜病变患者182例,根据病理胃镜诊断和病理诊断分为非贲门胃癌组(n=54)以及非胃癌组(n=128)。收集患者的一般资料和实验室指标,采用单因素和多因素分析非贲门胃癌发生的影响因素。结果非贲门胃癌患者的非贲门胃癌家族史、喜好烫食、合并脂肪肝、高盐饮食、吸烟、情绪抑郁、高毒力菌株情况多于非胃癌患者,差异均有统计学意义(χ^(2)分别=5.57、6.97、9.38、6.25、5.02、4.94、24.29,P均<0.05),胃蛋白酶原比值(PGⅠ/PGⅡ)以及高密度脂蛋白胆固醇(HDL-C)指标低于非胃癌患者,差异均有统计学意义(t分别=4.82、4.05,P均<0.05),甘油三酯(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)指标高于非胃癌患者,差异均有统计学意义(t分别=4.42、5.56、7.24,P均<0.05)。高毒力菌株、高TC以及高LDL-C是非贲门胃癌发生的危险因素(OR分别=11.81、2.53、11.02,P均<0.05),而高PGⅠ/PGⅡ是非贲门胃癌发生的保护因素(OR=0.24,P<0.05)。结论Hp高毒力菌株感染与非贲门胃癌的发生具有相关性。

Objective To investigate the correlation between Helicobacter pylori(Hp)infection with different toxin types and the risk for non-cardia gastric cancer.Methods A retrospective analysis of 182 patients with Hp-infected gastric mucosal lesions was performed.According to pathological gastroscopy and pathological diagnosis,they were divided into non-cardia gastric cancer group(n=54)and non-gastric cancer group(n=128).The general data and laboratory in⁃dexes of patients were collected,and the influencing factors of non-cardia gastric cancer were analyzed by univariate and multivariate analysis.Results The family history of non-cardia gastric cancer,preference for hot food,fatty liver,high salt diet,smoking,emotional depression and high virulence strains in patients with non-cardia gastric cancer were more than those in patients with non-gastric cancer,and the differences were statistically significant(χ^(2)=5.57,6.97,9.38,6.25,5.02,4.94,24.29,P<0.05).The levels of PGⅠ/PGⅡand HDL-C were significantly lower than those in non-gas⁃tric cancer patients(t=4.82,4.05,P<0.05).The levels of TG,TC and LDL-C were significantly higher than those in non-gastric cancer patients(t=4.42,5.56,7.24,P<0.05).High virulence strains,high TC and high LDL-C were risk fac⁃tors for non-cardia gastric cancer(OR=11.81,2.53,11.02,P<0.05),while high PGⅠ/PGⅡwas a protective factor for non-cardia gastric cancer(OR=0.24,P<0.05).Conclusion Hp hypervirulent strain infection is associated with the oc⁃currence of non-cardia gastric cancer.