自身免疫性胃炎并发结肠息肉患者CagA、胃黏膜功能和自身抗体的变化

Changes of CagA,gastric mucosa function and autoantibody in patients with autoimmune gastritis complicated with colonic polyps

目的分析自身免疫性胃炎并发结肠息肉患者CagA、胃黏膜功能和自身抗体的变化。方法纳入自身免疫性胃炎患者122例作为AIG组,另外收集同期萎缩性胃炎患者180例作为对照组。AIG组根据结肠是否有息肉,分为有、无增生性息肉组或有、无腺瘤性息肉组。比较各组血清胃泌素、细胞毒素相关基因A(CagA)、抗胃壁细胞抗体(PCA)、抗内因子抗体(IFA)、胃蛋白酶原Ⅰ/Ⅱ以及幽门螺杆菌感染情况。结果122例AIG患者中,73例患者幽门螺杆菌感染阳性,46例CagA阳性,43例PCA阳性,46例IFA阳性。AIG组结肠多发性增生性息肉和腺瘤性息肉发生率高于对照组(P<0.05)。有增生性息肉组幽门螺杆菌感染阳性率高于无增生性息肉组,有腺瘤性息肉组幽门螺杆菌感染阳性率和CagA阳性率高于无腺瘤性息肉组(P<0.05)。结论自身免疫性胃炎易伴有结肠增生性成腺瘤性息肉,可能与幽门螺杆菌感染有关。

Aim To analyze the changes of CagA,Gastric mucosa function and autoantibody in patients with autoimmune gastritis complicated with colonic polyps.Methods 122 patients with autoimmune gastritis were included as AIG group,and 180 patients with atrophic gastritis were collected as control group.The AIG group was divided into groups with and without proliferative polyps or with and without adenomatous polyps based on whether there are polyps in the colon.Serum Gastrin,cytotoxin associated gene A(CagA),anti-Parietal cell antibody(PCA),anti-intrinsic factor antibody(IFA),PepsinⅠ/Ⅱand Helicobacter pylori infection were compared in each group.Results Among the 122 AIG patients,73 were positive for Helicobacter pylori infection,46 were positive for CagA,43 were positive for PCA,and 46 were positive for IFA.The incidence of multiple proliferative polyps and adenomatous polyps in the colon of the AIG group was higher than that of the control group(P<0.05).The positive rate of Helicobacter pylori infection in the group with proliferative polyps was higher than that in the group without proliferative polyps.The positive rate of Helicobacter pylori infection and CagA in the group with adenomatous polyps was higher than that in the group without adenomatous polyps(P<0.05).Conclusion Autoimmune gastritis is commonly accompanied by colonic proliferative adenomatous polyps,which may be related to Helicobacter pylori infection.