胃印戒细胞癌发展及预后与幽门螺杆菌感染的关系研究

Study on the relationship between the development and prognosis of gastric signet-ring cell carcinoma and Helicobacter pylori infection

目的探究胃印戒细胞癌发展及预后与幽门螺杆菌(HP)感染的关系。方法回顾性分析2019年10月至2020年10月本院收治的80例胃黏膜病变患者的临床资料。比较不同胃黏膜病变患者HP阳性率,比较不同病理特征(临床分期、分化程度、淋巴结转移、TNM分期和Lauren分型)胃印戒细胞癌患者HP阳性率,采用Spearman系数分析胃印戒细胞癌与HP感染的相关性,比较胃印戒细胞癌组织和癌旁组织HP相对感染量,采用Kaplan-Meier法分析胃印戒细胞癌患者HP相对感染量与生存率的相关性。结果胃印戒细胞癌患者的HP阳性率高于慢性浅表性胃炎(P<0.05),其他病变患者HP阳性率两两比较差异均无统计学意义。进展期患者HP阳性率高于早期患者,差异有统计学意义(P<0.05);高分化患者HP阳性率高于中、低分化患者,差异有统计学意义(P<0.05);TNM分期Ⅳ期患者HP阳性率高于Ⅰ、Ⅱ、Ⅲ期患者,差异有统计学意义(P<0.05);Lauren分型为混合型患者HP阳性率高于肠型、弥漫型患者,差异有统计学意义(P<0.05)。经Spearman相关性分析显示,胃印戒细胞癌与HP感染呈正相关(r>0,P<0.05)。胃印戒细胞癌癌组织HP相对感染量[(12.41±4.31)]高于癌旁组织[(8.79±2.17)],差异有统计学意义(P<0.05)。Kaplan-Meier生存分析显示,HP相对感染量与胃印戒细胞癌生存率呈负相关(r<0,P<0.05)。结论胃印戒细胞癌发展及预后与HP感染率密切相关,HP阳性感染率升高,会增加胃印戒细胞癌发生风险,且患者预后越差,临床应予以重视。

Objective To explore the relationship between the development and prognosis of gastric signet-ring cell carcinoma and Helicobacter pylori(HP)infection.Methods The clinical data of 80 patients with gastric mucosal lesions admitted to our hospital from October 2019 to October 2020 were retrospectively analyzed.The positive rate of HP in patients with different gastric mucosal lesions,and the positive rate of HP in patients with gastric signet-ring cell carcinoma with different pathological characteristics(clinical stage,differentiation degree,lymph node metastasis,TNM stage and Lauren classification)were compared,the correlation between gastric signet-ring cell carcinoma and HP infection by Spearman coefficient,the relative infection amount of HP between gastric signet-ring cell carcinoma and para-carcinoma tissues were compared,and the correlation between infection amount and survival rate of HP in patients with gastric signet-ring cell carcinoma by Kaplan-Meier method.Results The positive rate of HP in patients with gastric signet-ring cell carcinoma was higher than that in patients with chronic superficial gastritis(P<0.05),and there was no significant difference in the positive rate of HP in patients with other diseases.The positive rate of HP in advanced patients was higher than that in early patients,and the difference was statistically significant(P<0.05);the positive rate of HP in well-differentiated patients was higher than that in moderately and poorly differentiated patients,and the difference was statistically significant(P<0.05);the positive rate of HP in patients with TNM stageⅣwas higher than that in patients with TNM stageⅠ,Ⅱ,Ⅲ,and the differences were statistically significant(P<0.05);the positive rate of HP in patients with mixed Lauren classification was higher than that in patients with intestinal type and diffuse type,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that gastric signet ring cell carcinoma was positively correlated with HP infection(r>0,P<0.05).The relative amount of HP infection in gastric signet ring cell carcinoma tissues([12.41±4.31])was higher than that in paracarcinoma tissues([8.79±2.17]),and the difference was statistically significant(P<0.05).Kaplan-Meier survival analysis showed that the relative amount of HP infection was negatively correlated with the gastric survival rate of signet-ring cell carcinoma(r<0,P<0.05).Conclusion The development and prognosis of gastric signet-ring cell carcinoma are closely related to the HP infection rate,the increase of HP positive infection rate will increase the risk of gastric signet ring cell carcinoma,and the worse the prognosis of patients,clinical attention should be paid to it.