幽门螺旋杆菌细胞毒素相关基因A、幽门螺旋杆菌分离株空泡形成毒素基因A与胃癌发生及临床病理因素的关系分析  

Analysis of the relationship between Helicobacter pylori cytotoxin-associated gene A, Helicobacter pylori isolate vacuole-forming toxin gene A and gastric cancer occurrence and clinicopathological factors

作　　者：杨海鹏 郝维敏[1] 夏宏林[1] Yang Haipeng;Hao Weimin;Xia Honglin(Department of Laboratory Medicine,Suzhou Hospital Affiliated of Anhui Medical University(Suzhou Municipal Hospital of Anhui Province),Anhui Suzhou 234000,China)

机构地区：[1]安徽医科大学附属宿州医院(安徽省宿州市立医院)检验科,234000

出　　处：《中国医师进修杂志》2021年第8期709-714,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:探讨幽门螺旋杆菌(HP)细胞毒素相关基因A(HP-CagA)、HP分离株空泡形成毒素基因A(HP-VacA)与胃癌发生及临床病理因素的关系。方法:选取安徽医科大学附属宿州医院2018年1月至2020年1月胃癌患者88例作为观察组,另选择同期良性胃部病变患者80例作为良性对照组,健康体检者80例作为健康对照组。比较三组临床资料、HP-CagA、HP-VacA阳性表达率,分析胃癌发生的危险因素,评价HP-CagA、HP-VacA与胃癌临床病理因素的关系。结果:有胃癌家族史、高盐饮食、喜好烫食、胃蛋白酶原(PG)Ⅰ/PGⅡ降低、合并脂肪肝及三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平升高、吸烟、情绪抑郁是胃癌发生的危险因素(P<0.05)。观察组HP-CagA、HP-VacA阳性表达率高于良性对照组、健康对照组[82.93%(73/88)比62.50%(50/80)和26.25%(21/80)、30.68%(27/88)比7.50%(6/80)和0](P<0.05)。HP-CagA、HP-VacA与胃癌患者年龄、病理类型、分化程度存在相关性,差异有统计学意义(P<0.05);Kaplan-Meier曲线分析结果显示,HP-CagA、HP-VacA阳性患者1年生存率低于阴性患者(P<0.05)。结论:HP-CagA、HP-VacA阳性HP感染与胃癌关系密切,加强对HP-CagA、HP-VacA阳性的HP感染患者的治疗,对切断胃癌早期发生环节、改善预后具有重要临床价值及社会意义。Objective To investigate the relationship between Helicobacter pylori(HP)cytotoxin-associated gene A(HP-CagA),HP isolate vacuole-forming toxin gene A(HP-VacA)and gastric cancer occurrence and clinical pathological factors.Methods Eighty-eight patients with gastric cancer from January 2018 to January 2020 in Suzhou Hospital Affiliated of Anhui Medical University was selected as the observation group,80 patients with benign gastric lesions during the same period was selected as the benign control group,and 80 healthy patients was selected as the healthy control group.The clinical data,HP-CagA,HP-VacA positive expression rates of the three groups were compared,the risk factors of gastric cancer were analyzed,and the relationship between HP-CagA,HP-VacA and gastric cancer clinicopathological factors were evaluated.Results Family history of gastric cancer,high-salt diet,preference for hot food,decreased pepsinogen(PG)Ⅰ/PGⅡ,combined with fatty liver,increased triglyceride,total cholesterol and low density lipoprotein cholesterin,smoking and depression were risk factors of gastric cancer(P<0.05).The positive rate of HP-CagA,HP-VacA in the observation group were higher than those in the benign control group and the healthy control group:82.93%(73/88)vs.62.50%(50/80)and 26.25%(21/80),30.68%(27/88)vs.7.50%(6/80)and 0,the differences were statistically significant(P<0.05).The positive of HP-CagA and HP-VacA had correlation with age,pathological type,and degree of differentiation of gastric cancer(P<0.05).The 1-year survival rate of HP-CagA and HP-VacA positive patients was lower than that of negative patients by Kaplan-Meier analysis(P<0.05).Conclusions The positive of HP-CagA and HP-VacA in HP infections are closely related togastric cancer.Strengthening the treatment of HP infection patients with positive HP-CagA and HP-VacA has important clinical value and social significance for cutting off the early stage of gastric cancer and improving prognosis.

关 键 词：螺杆菌 幽门 胃肿瘤 细胞毒素相关基因A 分离株空泡形成毒素基因A 预后 

分 类 号：R735.2[医药卫生—肿瘤]