长沙市2889例3月～16岁儿童幽门螺旋杆菌感染现状及对生长发育的影响分析

本研究对长沙市2889名3月~16岁无症状体检儿童进行了生长发育评估,并通过胶体金法检测了其血清幽门螺旋杆菌(Helicobacter pylori)IgG水平。结果显示共检测的2889名儿童(男童1652名,女童1237名)中幽门螺旋杆菌感染阳性765名(26.4%),男童432名(26.2%),女童333(26.9%)。各年龄组幽门螺旋杆菌感染率分别为3月~1岁为31.8%、1岁~3岁为31.4%、3岁~6岁为18.9%、6岁以上15.4%。采用卡方检验及非参数检验进行统计,结果显示男女两组儿童幽门螺旋杆菌感染率无统计学差异(P>0.05)。3月~1岁与1岁~3岁、3岁~6岁与6岁以上组间幽门螺旋杆菌感染率无差异,其余组两两间均有差异。幽门螺旋杆菌感染阴性组儿童的身长/身高与幽门螺旋杆菌感染阳性组间无统计学差异(P>0.05),而幽门螺旋杆菌感染阴性组儿童的体重与幽门螺旋杆菌感染阳性组间有统计学差异(P<0.001);幽门螺旋杆菌感染阳性组与幽门螺旋杆菌感染阴性组中营养不良或矮身材发生率不具有统计学差异(P>0.05)。结果表明,幽门螺旋杆菌的感染在儿童群体中并无性别差异,并未使儿童的身材/身高、以及矮身材、营养不良等严重生长发育性疾病的发病率增加,但可能对儿童的体重带来一定影响。     

NF-κB在幽门螺杆菌感染介导的胃癌发生发展中的作用

目的:探讨核因子-κB(nuclear factor-κB,NF-κB)在幽门螺杆菌感染介导的胃癌发生发展中的作用。方法:选择2016年3月至2019年3月在本院诊治的胃部疾病患者110例,采用qPCR检测NF-κB相对表达情况,采用免疫印记法检测幽门螺杆菌(Helicobacter pylori,Hp)感染情况并进行相关性分析。结果:在110例患者中,病理诊断为胃癌9例(胃癌组)和良性胃部疾病101例(良性组,其中浅表性胃炎52例、萎缩性胃炎26例、不典型增生23例)。胃癌组的幽门螺杆菌感染率为88.9%,显著高于良性组的10.9%(P0.05)。胃癌组的NF-κB表达阳性率为77.8%,显著高于良性组的14.9%(P0.05)。在110例患者中,直线相关性分析显示幽门螺杆菌感染、NF-κB表达阳性与胃癌有显著正相关性(P0.05)。受试者工作特征曲线(receiver operating characteristic curve,ROC)显示幽门螺杆菌感染、NF-κB表达阳性鉴别诊断胃癌的曲线下面积分别为0.669和0.713。结论:NF-κB在胃癌中呈现高表达状况,也多伴随有幽门螺杆菌感染,两者存在显著相关性,共同介导胃癌的发生发展。     

胃癌的临床诊断、形成机理以及临床治疗

胃癌(Gastric cancer)是发生在胃部黏膜的癌症,其公认的致病原因是由于感染幽门螺旋杆菌(Heli-cobacterpylori)引起慢性萎缩性胃炎及一些免疫发炎反应.大约有10％的胃癌病例与家族遗传有关,胃癌发生主要与生活环境、饮食习惯、遗传与免疫因素以及慢性胃病等有关.胃癌临床治疗方式通常包括:外科手术、化学治疗、放射线治疗以及标靶治疗.多数早期胃癌经治疗能够痊愈,而到了末期则治疗成效不佳.一般而言,胃癌病人平均五年存活率大约为22％左右,而晚期胃癌患者五年存活率则小于5％.     

MIF mRNA在胃窦胃癌组织中的表达及其与幽门螺杆菌感染的关系

目的:探讨胃窦胃癌组织中人巨噬细胞移动抑制因子MIF mRNA的表达,并分析其与幽门螺杆菌感染的关系,分析二者在胃窦胃癌发生中的相关性。方法:选取2013年1月至2014年12月于我院收治的胃窦胃癌患者30例作为观察组,另随机选择10例胃窦胃炎患者作为对照组,采用14C-尿素呼气试验(UBT)检测各组患者有无幽门螺杆菌感染,定量逆转录PCR检测观察组患者及对照组患者组织中MIF mRNA表达。统计分析不同组织中MIF mRNA表达与幽门螺杆菌感染之间的关系。结果:观察组组织中MIF mRNA的表达为(1.09±0.11),高于对照组组织的(0.21±0.08),差异具有统计学意义(P0.05)。进一步亚组分析,观察组合并幽门螺杆菌感染组织中MIF mRNA的表达为(1.24±0.14),高于非幽门螺杆菌感染者的(1.09±0.11),差异具有统计学意义(P0.05)。结论:MIF mRNA在胃窦胃癌组织中高表达,幽门螺杆菌感染促进了MIF mRNA的表达,共同促进了胃窦胃癌的发生发展。     

幽门螺旋杆菌感染与胃癌中Shh和C-myc表达的关系

为了探讨胃癌中幽门螺旋杆菌(Hp)感染和Sonic Hedgehog(Shh)、C-myc表达,它们之间的相关性以及胃癌发生的可能机制,采用免疫组化法检测89例胃癌组织及20例正常胃上皮组织中Shh及C-myc的表达。并采用快速尿素酶试验,组织病理学检测两种方法检查Hp。实验结果显示,胃癌组织Shh的表达要明显高于正常上皮组织,二者之间有显著差异(P<0.05);胃癌组织C-myc的表达水平也高于正常胃上皮组织,二者之间有显著差异(P<0.05);Hp阳性的C-myc阳性表达率明显高于Hp阴性,二者之间有显著差异(P<0.05);Shh表达阳性率在Hp阳性和阴性胃癌中无显著差异(P>0.05)。结果提示,胃癌的发生与癌基因Shh及C-myc的过度表达有关,Hp感染的致癌机制中可能有癌基因C-myc参与。     

TFF2在胃癌中的表达及与幽门螺杆菌感染关系的研究

目的探讨三叶因子Ⅱ(Trefoil factors2,TFF2)在胃癌和癌前病变中的表达及与幽门螺杆菌感染(Helicobacter pylori,H.pylori)的关系。方法选取经病理证实的慢性浅表性胃炎、胃溃疡、慢性萎缩性胃炎和胃癌4种不同胃黏膜病变的标本140例,用免疫组化法检测标本中TFF2的表达及H.pylori的感染情况,并分析TFF2的表达与H.pylori的感染的关系。结果在慢性浅表性胃炎、胃溃疡、慢性萎缩性胃炎和胃癌中,TFF2和H.pylori的表达率依序呈逐渐增加的趋势,但TFF2在胃癌组织中表达降低。H.pylori阳性组TFF2的表达率低于阴性组,TFF2的阳性率与H.pylori感染率之间呈负相关(r=-0.335,P<0.05)。结论 TFF2的表达和H.pylori的感染与肿瘤的发生密切相关,检测该指标可为胃癌诊断、判断预后和指导治疗提供理论依据。     

幽门螺杆菌及其细胞毒素相关蛋白A与胃癌形成的关系及可能机制

目的通过检测慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、肠上皮化生(IM)、不典型增生(DYS)、胃癌(GC)组织幽门螺杆菌(Hp)和细胞毒素相关蛋白A(CagA)基因、P53、一氧化氮合成酶(iNOS)的表达,探讨Hp、CagA基因、P53、iN-OS与胃癌相关性及其参与胃癌形成的可能机制。方法应用快速尿素酶试验和组织切片革兰氏染色和血清HpCagA抗体检测Hp表达,用PCR检测HpCagA基因表达,用免疫组化SP法检测上述组织的突变P53蛋白、iNOS表达。结果 CSG、CAG、IM、DYS、GC组织中Hp检出率分别为46.7%、67.2%、70.0%、75.3%和53.8%,相应组织中HpCagA检出率分别为34.3%、59.0%、65.7%、69.1%和76.8%,GC组Hp感染率与DYS组相比差异显著(P<0.05),而CAG、IM、DYS组与CSG组Hp感染率相比差异显著(P<0.05)。IM、DYS、GC组CagA+株感染率则高于CSG组(P<0.01-P<0.05),GC组CagA+株感染率则高于CAG组(P<0.05)。从CSG到GC胃粘膜演变中,CagA基因阳性组中的突变P53、iNOS表达逐渐升高;除CSG外,CAG、IM、DYS、GC组CagA基因阳性组突变P53表达明显高于CagA基因阴性组突变P53表达(P<0.005-P<0.05);CSG、CAG、IM、DYS、GC组CagA基因阳性组iNOS表达均高于CagA基因阴性组iNOS表达(P<0.005-P<0.05)。结论 Hp特别是CagA基因与胃癌形成有关,Hp、CagA引起iNOS表达增高,P53基因突变,在形成胃癌中发挥作用,但P53基因突变在胃癌形成中属于较晚期事件。     

幽门螺旋杆菌ATCC 43504感染BALB/c小鼠动物胃炎模型的建立及分析

利用幽门螺旋杆菌标准菌株建立稳定可靠的幽门螺旋杆菌(Helicobacter pylori,Hp)感染小鼠胃炎模型对Hp疫苗研制、Hp致病机制的研究及抗Hp药物的筛选具有重要意义。通过灌胃国际标准菌株幽门螺旋杆菌Hp ATCC 43504,构建了BALB/c小鼠动物胃炎模型。利用小鼠胃部Hp尿素酶活性检测、Hp的定量培养、PCR检测、组织病理学等多种方法鉴定BALB/c小鼠动物胃炎模型。通过Hp诊断试剂盒检测,造模组小鼠的胃组织能使Hp尿素酶试剂变色,呈现玫瑰红色,而健康小鼠的胃组织不能使Hp尿素酶试剂变色,依旧呈现黄色;通过小鼠胃组织匀浆液培养Hp,造模组小鼠的胃组织匀浆液均可在BHI血平板长出Hp菌落,而对照组小鼠的胃组织匀浆液不能培养出Hp菌落;利用PCR对造模组和对照组BALB/c小鼠的胃组织进行Hp检测,造模组小鼠胃组织可扩增出150 bp的DNA产物,而对照组小鼠胃组织无扩增产物;通过HE染色法观察小鼠胃部病理变化和炎症情况,与健康BALB/c小鼠比较,造模组小鼠胃粘膜和粘膜下层有大量白细胞浸润,胃部炎症明显。利用国际标准菌株Hp ATCC 43504菌株成功构建了BALB/c小鼠胃炎模型,为评价防治Hp感染药物的效果奠定了实验基础。     

霉菌、幽门螺杆菌及双菌种感染在胃溃疡、胃癌中检出的意义

探讨霉菌、幽门螺杆菌(Hp)单菌种感染和霉菌、Hp(双菌种)同时感染在胃癌及胃溃疡中的组织病理学变化、发病情况及意义。采用常规石蜡切片,HE染色和PAS、Giemsa特殊染色、免疫组织化学染色及PCR方法,对223例慢性浅表性胃炎、111例慢性萎缩性胃炎、116例胃溃疡、121例胃癌纤维胃镜活检标本进行回顾性研究。结果显示,慢性浅表性胃炎、慢性萎缩性胃炎未检出双菌种感染。胃溃疡双菌种感染11例,检出率9.5%;胃癌双菌种感染21例,检出率17.4%。双菌种感染在胃癌及胃溃疡中的发现,表明双菌种感染可能是导致胃溃疡、胃癌发生的又一致病因素。     

牙斑幽门螺杆菌与慢性胃炎之间的关系

目的研究牙斑幽门螺杆菌与慢性胃炎之间的关系。方法对胃炎组、胃炎治疗组分别进行牙斑和胃黏膜幽门螺杆菌培养和比较。结果牙斑细菌培养：胃炎组阳性14例,阳性率为12．8％;治疗组阳性11例,阳性率为10．1％。胃黏膜细菌培养：胃炎组阳性47例,阳性率为43．1％;治疗组阳性19例,阳性率为17．4％。治疗前后比较牙斑标本差异无显著性（P〉0．05）,胃黏膜标本差异有非常显著性（P〈0．001）。结论牙斑中确实存在着幽门螺杆菌,而且是胃内反复感染的源泉,以致慢性胃病反复发作,难以治愈。     

幽门螺杆菌感染性胃癌组织中cyclinD1、MMP-9的表达及其临床意义

目的:探讨幽门螺杆菌(HP)感染性胃癌组织中细胞周期蛋白D1(cyclinD1)、基质金属蛋白酶-9(MMP-9)的表达及其临床意义。方法:选取2016年12月到2018年6月期间在兰州大学第一医院接受治疗的胃癌患者80例,收集其手术切除的病理组织。采用C-14呼气试验和改良Giemsa染色检测患者HP感染的情况,采用免疫组化法检测胃癌组织中cyclinD1、MMP-9表达情况。分析HP感染、cyclinD1、MMP-9表达与胃癌患者临床病理特征的关系,并分析胃癌患者HP感染与cyclinD1、MMP-9表达的相关性。结果:80例胃癌患者HP感染阳性56例(70.00%),阴性24例(30.00%)。有淋巴结转移、浸润深度为T3+T4的胃癌患者的HP感染阳性率高于无淋巴结转移、浸润深度为T1+T2的胃癌患者(P0.05)。80例胃癌患者cyclinD1阳性表达45例(56.25%),阴性表达35例(43.75%),MMP-9阳性表达65例(81.25%),阴性表达15例(18.75%),TNM临床分期为III+IV期、分化程度为低分化、有淋巴结转移、浸润深度为T3+T4的胃癌患者的cyclinD1、MMP-9阳性表达率明显高于TNM临床分期为I+II期、分化程度为中高分化、无淋巴结转移、浸润深度为T1+T2的胃癌患者(P0.05)。HP感染阳性患者的cyclinD1阳性表达率和MMP-9阳性表达率均明显高于HP感染阴性患者(P0.05)。Pearson相关分析显示,胃癌患者HP感染与cyclinD1、MMP-9表达均呈正相关(P0.05)。结论:胃癌患者的HP感染情况与淋巴结转移、浸润深度有关,cyclinD1和MMP-9的表达与TNM临床分期、分化程度、淋巴结转移、浸润深度有关,且胃癌患者HP感染与cyclinD1、MMP-9表达均呈正相关。     

胃癌病理特征改变与幽门螺旋杆菌感染的相关性分析

目的:探究HP感染与胃癌患者病理特征性改变的相关性。方法:选取我院消化内科收治并确诊为胃癌的患者50例,作为胃癌组;确诊为慢性浅表性胃炎的患者50例,作为胃炎组;选取同期进行健康体检未发现胃部异常的患者50例,作为对照组。对三组患者进行快速尿素氮试验、13C尿素呼气试验以及血清抗HPCag A等检查,比较患者HP感染等情况。结果:胃癌组及胃炎组患者HP感染阳性率及抗HPCag A阳性率显著高于对照组,且胃癌组较胃炎组明显增高,差异有统计学意义(P0.05)。胃癌早期及进展期患者HP感染率高于对照组,差异有统计学意义(P0.05)。胃癌组患者非贲门部HP感染率显著高于贲门部及对照组,差异有统计学意义(P0.05)。结论:HP感染是导致胃癌的主要因素,明确HP感染与胃癌病理分期及病变部位的相关性对胃癌的治疗及预防有重要的临床意义。     

Genetic factors in the development of gastric precancerous lesions--a role of Helicobacter pylori ?

Helicobacter pylori is believed to predispose to gastric cancer by inducing gastric precancerous alterations. There is a well known predisposition to gastric cancer and the risk of developing it is greater in relatives of patients with familial cases of this malignancy. The aim of this study was to determine the prevalence of gastric precancerous lesions (atrophy and intestinal metaplasia) and their association with Hp infection in first-degree relatives in patients with noncardia gastric cancer. METHODS: Hp status and gastric histology assessed by upper gastrointestinal endoscopy, biopsies from the antral and body region, the rapid urease test and staining for Hp, inflammation, activity, atrophy and intestinal metaplasia (prevalence and grading) were studied in 108 first-degree relatives of patients with noncardia gastric cancer and compared with 73 controls with mild non-ulcer dyspepsia who had no cancer relatives and were examined in the same way. RESULTS: subjects with and without cancer relatives had a similar prevalence of Hp infection (49 vs. 47%). Endoscopy revealed a few asymptomatic duodenal ulcers and small hiatus hernias in Hp positive subjects of both groups. Hp positive relatives of gastric cancer had a markedly higher prevalence of atrophy than those with Hp negativity without cancer relatives (29 vs. 9%) and those with Hp negativity and cancer relatives (29 vs. 3%. Prevalence of intestinal metaplasia was also higher in those with Hp positivity and cancer relatives than in those without cancer relatives (15 vs. 5% and was not present in Hp negative subjects with cancer relatives. Inflammation and activity showed similar scores in subjects with and without cancer relatives with higher scores in both Hp positive groups. The prevalence of precancerous lesions in the relatives of gastric cancer was nearly always confined to those with Hp positivity. One year after eradication the prevalence of atrophy in cancer relatives decreased from 29 to 14%; prevalence of intestinal metaplasia remained without substantial changes. Scores for inflammation and activity were also lower after eradication. CONCLUSIONS: First-degree relatives of patients with gastric cancer have an increased prevalence of gastric precancerous abnormalities which are strongly confined to those with Hp infection. Eradication of Hp in these subjects with cancer relatives reduces the prevalence of precancerous lesions (atrophy) and grades of inflammation and activity. In view of these results, eradication of Hp should be offered to such subjects.     

Ezrin在胃癌组织中的表达及与Hp-L型感染关系的探讨

目的通过检测胃癌组织中幽门螺杆菌L(Helicobacter pyloriL-form,Hp-L)型感染以及Ezrin的表达情况,探讨Hp-L型、Ezrin在胃癌组织中的表达及临床意义。方法 (1)应用革兰染色法和免疫组织化学Elivision法检测80例胃癌组织和40例对照组织中的Hp-L型感染情况。(2)应用免疫组织化学Elivision法检测上述各组织中Ezrin蛋白的表达。(3)应用逆转录多聚酶链反应(RT-PCR)法检测30例新鲜胃癌组织及与其相对应的30例远端切缘正常组织中Ezrin mRNA的表达。结果 (1)胃癌组中革兰染色L型的检出率为80.00%(64/80)、免疫组化Hp-L型阳性率81.25%(65/80),两种方法检测的结果具有一致性(P0.05)。80例胃癌组织中Hp-L型阳性(即革兰染色L型检出阳性和免疫组化Hp-L型抗原表达同时阳性)的病例数为56例,其阳性率为70.00%;对照组中革兰染色L型检出率为22.50%(9/40),免疫组化Hp-L型阳性率40%(16/40)二者检测结果也具有一致性(P0.05)。40例对照组织中Hp-L型阳性例数为9例,其阳性率为22.50%。胃癌组与对照组的Hp-L型阳性率相比,差异具有统计学意义(P0.05);(2)胃癌组Hp-L型感染阳性率仅与胃癌的淋巴结转移有关(P0.05),而与其他临床病理因素无关;(3)RT-PCR法和免疫组织化学Elivision法显示胃癌组中Ezrin mRNA及Ezrin蛋白的表达均高于对照组(P0.05),且经统计学分析发现Ezrin表达水平与胃癌细胞的分化程度、浸润深度及淋巴结转移有关(P0.05),而与临床分期、患者的年龄及性别无关(P0.05);(4)胃癌中Hp-L型阳性组的Ezrin蛋白表达阳性率71.43%(40/56)高于Hp-L阴性组54.17%(13/24)(P0.05),且Hp-L型阳性和Ezrin蛋白阳性呈正相关(r=0.456,P0.05)。结论 Hp-L型感染阳性率和Ezrin表达阳性率在胃癌中均较高,二者可能协同促进胃癌的发生发展及浸润转移。     

Helicobacter pylori-negative gastric cancer in South Korea: incidence and clinicopathologic characteristics

Background and Aim: It is difficult to determine the exact incidence rate of Helicobacter pylori (H. pylori) infection‐negative gastric cancer (HPIN‐GC) because H. pylori detection rates decrease with the progression of gastric atrophy and intestinal metaplasia. The aim of this study was to evaluate the incidence and clinicopathologic characteristics of HPIN‐GC in South Korea. Methods: Helicobacter pylori infection status was evaluated by histology, a rapid urease test (CLO test), culturing, serology, and history of H. pylori eradication for 627 patients with gastric cancer. Current H. pylori infection was defined as positive results from histology, the CLO test, and culturing. Previous H. pylori infection was defined as negative in all three biopsy‐based tests and positive serology or history of H. pylori eradication. Patients were considered to be negative for H. pylori infection if all results from five methods were negative. However, patients who were found to have severe gastric atrophy by the serum pepsinogen test or metaplastic gastric atrophy by histology were assumed to have had a previous H. pylori infection even if results from other tests for H. pylori infection were all negative. Results: The number of patients with gastric cancer with current or previous H. pylori infection was 439 (70.0%) and 154 (24.6%), respectively. The rate of HPIN‐GC occurrence was 5.4% (n = 34). Sex, age, Lauren type, location of the tumor, and treatment modalities were not different according to H. pylori infection status. However, HPIN‐GC had a more advanced pT classification (T3/T4; 51.9 vs 31.1%, p = .025) and a more advanced stage (more than stage I; 63 vs 41.3%, p = .027) than H. pylori‐positive gastric cancer. Conclusion: At least 5.4% cases of gastric cancer were H. pylori negative among South Korean patients. HPIN‐GC looks like to have a poorer prognosis than H. pylori‐positive cases.     

FAK在胃癌组织中的表达及与Hp-L型感染的关系

目的探讨局部黏着斑激酶(focal adhesion kinase,FAK)在胃癌组织中的表达意义及与幽门螺杆菌L型(Helicobacter pylori-L,Hp-L)感染的关系。方法 (1)应用免疫组织化学Elivision法检测120例胃癌组织及40例切缘正常胃粘膜组织(对照组)中FAK蛋白的表达情况,采用免疫组织化学和革兰染色法检测Hp-L型的感染情况;(2)采用逆转录多聚酶链反应(RT-PCR)技术检测40例新鲜胃癌组织及对应切缘正常胃黏膜组织(对照组)中FAK的mRNA表达。结果胃癌组FAK蛋白的表达阳性率高于对照组(P0.05),且FAK的高表达与分化程度、浸润深度、淋巴结转移和TNM分期有关(P0.05),与年龄、性别、肿瘤大小无关(P0.05);RT-PCR显示,肿瘤组织、远端正常对照组织的FAK表达量差异明显(P0.01)。胃癌组Hp-L型检出率72.5%(87/120)与对照组37.5%(15/40)有显著性差异(P0.05),与免疫组化Hp-L型抗原表达率65.0%(78/120)无显著性差异(P0.05),Hp-L检出阳性率为69.2%(83/120);胃癌组中Hp-L型感染阳性组的FAK表达阳性率高于Hp-L型阴性组(P0.05),且Hp-L型阳性率和FAK蛋白的表达呈正相关(r=0.291,P0.05)。结论FAK蛋白和mRNA在胃癌中的表达增加,且与胃癌的浸润、转移相关,其机制可能与幽门螺杆菌L型(Hp-L型)感染有关。     

慢性胃病患者胃蛋白酶原I、II水平与幽门螺旋杆菌感染的关系研究

目的:探讨慢性胃病患者胃蛋白酶原(PG)Ⅰ、PG Ⅱ水平与幽门螺旋杆菌(HP)感染的关系。方法:选取2012年12月-2016年12月期间我院收治的慢性胃病患者64例作为研究对象,根据疾病类型分为慢性胃炎组23例、胃溃疡组22例以及胃癌组19例。另取同期于我院接受体检的健康志愿者30例作为对照组,应用免疫比浊法测定各组血清PG Ⅰ与PG Ⅱ水平,采用快速尿激酶法测定各组HP感染情况,分别对比各组研究对象HP感染发生情况,血清PG Ⅰ、PG Ⅱ、PG Ⅰ/PG Ⅱ水平,HP感染情况与血清PG Ⅰ、PG Ⅱ、PG Ⅰ/PG Ⅱ水平关系。结果:慢性胃炎组、胃溃疡组以及胃癌组患者HP阳性率分别为60.87%、63.64%、78.95%,均明显高于对照组的13.33%(P0.05)。慢性胃炎组、胃溃疡组以及胃癌组患者血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平均低于对照组,且胃癌组低于慢性胃炎组与胃溃疡组(P0.05),慢性胃炎组和胃溃疡组血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平比较差异无统计学意义(P0.05),各组血清PG Ⅱ比较无统计学差异(P0.05)。各组研究对象HP阳性血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平均低于HP阴性(P0.05),而PG Ⅱ水平比较无统计学差异(P0.05),慢性胃炎组、胃溃疡组、胃癌组HP阳性血清PG Ⅰ水平低于对照组,且胃癌组低于慢性胃炎组、胃溃疡组(P0.05),胃溃疡组、胃癌组HP阳性血清PG Ⅰ/PG Ⅱ水平低于对照组,且胃癌组低于慢性胃炎组(P0.05)。结论:慢性胃病患者PG Ⅰ、PG Ⅱ水平异常降低,HP阳性患者PG Ⅰ、PG Ⅱ水平降低更为明显,随病变的程度增加,血清PG Ⅰ、PG Ⅰ/PG Ⅱ水平也呈现出下降的趋势。     

Study on the association of p53 codon 72 polymorphisms with risk of gastric cancer in high incidence Hexi area of Gansu Province in China

To investigate the possible association of P53 codon 72 Arg/Pro polymorphisms with risk of gastric cancer in the high incidence Hexi area of Gansu province in China. Blood samples from 140 patients with gastric carcinoma and 125 healthy controls were collected in Hexi area of Gansu province. Polymorphism of P53Arg72Pro was genotyped by PCR-TaqMan. For detection Helicobacter pylori infection, Warhin–Starry staining was used. Three kinds of polymorphisms of P53Arg72Pro were Arg/Arg, Arg/Pro, Pro/Pro. The frequencies in gastric cancer group were 15.7, 60.0, 24.3%, and the frequencies in healthy controls were 25.6, 54.4, 20.0%, respectively. P53 codon 72 Pro carrier genotype (Arg/Pro + Pro/Pro) increased risk of gastric carcinoma with an odds ratio 1.840 (95% CI: 1.006–3.387). Helicobacter pylori infection rate was 68.6% in patients group and 50.4% in healthy controls. Helicobacter pylori infection rate in gastric cancer patients was remarkably higher than that in the controls (OR: 2.147, 95% CI: 1.302–3.541, P = 0.003). Stratification analysis showed that P53 codon 72 Pro carrier genotype with Helicobacter pylori infection was significantly higher in cases than that in the controls (OR: 4.182, 95% CI: 1.850–9.454). P53Arg72Pro polymorphisms could be a risk factor for gastric cancer in high incidence Hexi area of Gansu Province in China. P53 codon 72 Pro carrier genotype and Helicobacter pylori positive infection may have a synergistic effect on gastric cancer in high incidence Hexi area of Gansu Province in China.     

Low prevalence of Helicobacter pylori-negative gastric cancer among Japanese

Background and Aims: The true prevalence of Helicobacter pylori‐negative gastric cancer (HpNGC) is unknown. We attempt to clarify the prevalence and clinicopathologic features of HpNGC in Japanese. Methods: Helicobacter pylori infection was detected by antibody titer and microscopic observation. In addition, we confirmed the lack of endoscopic atrophy and histologic gastritis. In these cases, we added urea breath test or rapid urease test to confirm the absence of H. pylori. The mucus phenotype of gastric cancer tissue was also evaluated by immunohistochemistry. Results: We screened 3161 gastric cancer cases from 1996 to 2010, and 21 cases were regarded as H. pylori negative. Clinically, patients with HpNGC were younger than patients with H. pylori‐positive gastric cancer (controls), and revealed a lack of male dominancy. Histologically, diffuse type was frequently found. All patients examined were pepsinogen negative. Among HpNGC cases with endoscopic resection, the depressed macroscopic appearance was dominant. The prevalence of HpNGC was calculated as 0.66% (95% confidence interval = 0.41–1.01). The mucus phenotype of HpNGC was similar to that of the controls. Conclusion: The prevalence of HpNGC is very low and its pathological characteristics are different from common gastric cancer.     

Study on the association of COX-2 genetic polymorphisms with risk of gastric cancer in high incidence Hexi area of Gansu province in China

To investigate the possible association of polymorphisms, cyclooxygenase-2 (COX-2) promoter region −899G>C, COX-2 codon 587G>A, with risk of gastric cancer in the high incidence Hexi area of Gansu province in China. Blood samples from 140 patients with gastric carcinoma and 125 normal persons were collected in Hexi area of Gansu province in China. Polymorphisms of COX-2 −899G>A and COX-2 587G>A were genotyped by PCR-TaqMan. For detection Helicobacter pylori infection, Warhin–Starry staining was used. Three kinds of polymorphisms of COX-2 −899G>C were GG, GC and CC. The frequencies in gastric cancer patients were 72.9, 21.4 and 5.7%, and the frequencies in controls were 84.0, 12.8 and 3.2%, respectively. COX-2 −899C carrier (GC + CC) increased risk of gastric carcinoma with an odds ratio 1.950 (95% CI: 1.067–3.586, P = 0.029). The genotype of COX-2 587G>A polymorphism were GG, GA and AA. The frequencies in patients group were 86.4, 11.4 and 2.2%, and the frequencies in controls were 89.6, 9.6 and 0.8%, respectively. There was no significant difference between cases and controls in each genotype. Helicobacter pylori infection rate was 68.6% in patients group and 50.4% in healthy controls. Helicobacter pylori infection rate in gastric cancer patients was remarkably higher than that in normal people (OR: 2.147, 95% CI: 1.302–3.541, P = 0.003). Stratification analysis was showed that COX-2 −899C carrier genotype with Helicobacter pylori infection was significantly higher in cases than that in healthy controls (OR: 4.000, 95% CI: 1.638–9.770). The polymorphism of COX-2 −899G>C could be a risk factor for gastric cancer in high incidence Hexi area of Gansu Province in China. COX-2 −899C carrier genotype and Helicobacter pylori positive infection may have a synergistic effect on gastric cancer in high incidence Hexi area of Gansu Province in China. However, the polymorphisms of COX-2 587G>A is no association with gastric cancer in the high incidence Hexi area of Gansu Province in China.