幽门螺杆菌感染与胃癌临床病理特点相关性研究(附125例分析)  

Correlation analysis of Helicobacter pylori infection to the clinicopathological features of gastric cancer:An analysis of 125 patients

作　　者：刘凯[1] 张维汉[1] 杨昆[1] 陈心足[1] 张波[1] 陈志新[1] 陈佳平[1] 周总光[1] 胡建昆[1] 

机构地区：[1]四川大学华西医院胃肠外科中心,四川成都610041

出　　处：《中国实用外科杂志》2014年第10期974-977,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81372334;No.81301867;No.81301866);国家教育部新世纪优秀人才支持计划(No.2012SCU-NCET-11-0343)

摘　　要：目的探讨幽门螺杆菌（Hp）感染与胃癌临床病理特点的相关性。方法回顾性分析2013年5月至2014年5月四川大学华西医院胃肠外科收治的125例行胃癌切除术病人的病例资料。术前行碳-14尿素呼气试验检测，根据检测的碳-14同位素每分钟衰变数（DPM值）分为Hp阳性组和Hp阴性组，对比分析两组胃癌病人的临床病理特点。结果碳-14尿素呼气试验结果示Hp阳性者62例（49．6％），阴性者63例（50．4％）。Hp阳性病人中，胃下1／3癌的比例较阴性明显增高（69．4％VS．49．2％），而胃中部1／3癌的比例较低（6．5％VS．20．6％），差异有统计学意义（P=0．047）；与Hp阴性组相比，Hp阳性组中管状腺癌的比例较高（53．2％VS．30．2％，P=O．009），人类表皮生长因子受体-2（Her-2）的阳性表达率亦较高（52．1％YS．25．5％，P=0．005），但两组病人在肿瘤大小、浸润深度、淋巴结转移数目及肿瘤分化程度等方面的差异均无统计学意义，Logistic回归多因素分析示胃癌组织Her-2表达是Hp阳性的独立危险因素[P=O．006，Exp（B）=0．314，95％CI（0．137～0．720）]。结论幽门螺杆菌与胃癌的发病部位和Her-2表达有-定的相关性，但其对胃癌分期及预后的影响需要进一步研究。Objective To investigatethe ciinicopathological features of gastric cancer based on Helicobacter pylori （Hp） status. Methods The clinical data of 125 patients who underwent gastrectomy for gastric cancerbetween May 2013 and May 2014 in the Department of Gastrointestinal Surgery, West China Hospital of Sichuan University were analyzedretrospectively. 14C urea breath test （14C-UBT） was applied to define the status of Hp. Patients were divided into two groups （HP positive and HP negative）.The differences of clinicopathological characteristics were compared between two groups. Results The outcome of 14C-UBT showed there were 62 patients （49.6%） with Hppositive and 63 patients （50.4%） negative. For patients with HP positive, the proportion of lower third gastric cancer was higher （69.4% vs.49.2% ）, while the middle third gastric cancer was lower （6.5% vs.20.6%） （P=0.047）. The proportion of tubular adenocarcinoma and the expressive rate of Her-2 were higher in HP positive patients than that of patients without Hp infection（53.2%vs.30.2%, P=O.009） （52.1%vs.25.5%, P=0.005）. However, in the current study there was no significant difference on tumor size, depth of tumor invasion, lymph nodes metastasis, distant metastasis and grade of histological type between two groups.The expression of Her-2 in gastric cancer patients had independent correlation with Hp positive by Logistic regression analysis [P=0.006, Exp（B）=0.314,95%CI（0.137-0.720）].Conclusion Hp may have relationshipwith the tumor location and expression of Her-2 in gastric cancer patients, while the correlation to tumor stage and prognosis is needed to be further investigated.

关 键 词：胃癌 幽门螺杆菌 病理学 

分 类 号：R6[医药卫生—外科学]