| 石振旺,方东,鲍德明,等.胃癌高发地区慢性萎缩性胃炎血清幽门螺杆菌抗体分型情况以及癌变风险的差异[J].安徽医药,2023,27(2):332-336. |
| 胃癌高发地区慢性萎缩性胃炎血清幽门螺杆菌抗体分型情况以及癌变风险的差异 |
| Differences in serum Hp antibody typing and cancer risk in chronic atrophic gastritis in areas with a high prevalence of gastric cancer |
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| DOI：10.3969/j.issn.1009-6469.2023.02.027 |
| 中文关键词: 胃炎，萎缩性 癌症早期检测 幽门螺杆菌 胃蛋白酶原 胃炎分期 |
| 英文关键词: Gastritis,atrophic Early detection of cancer Helicobacter pylori Pepsinogen Gastritis staging |
| 基金项目:合肥市卫生健康委员会应用医学研究重点项目( hwk2019ZD008)；蚌埠医学院自然科学类重点项目( 2020byzd298) |
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| 中文摘要: |
| 目的分析胃癌高发地区慢性萎缩性胃炎( CAG)病人血清幽门螺杆菌( Hp)抗体分型情况以及癌变风险的差异。方法纳入 2019年 12月至 2021年 1月合肥市第二人民医院就诊的 168例 CAG病人作为研究对象，采用蛋白质印迹法检测血清 Hp抗体分型( CagA、VacV、Ure)，分为 Ⅰ型 Hp组、 Ⅱ型 Hp组和阴性组；酶联免疫吸附测定( ELISA)检测胃黏膜功能［胃蛋白酶原( PG)Ⅰ、PGⅡ、胃蛋白酶原比值( PRG)、胃泌素 17(G17)］采用“改良 ABC法”进行癌变风险分层，参考“木村 -竹本”分类法对萎缩范围分级，根据萎缩部位和程度进行 OLGA分期。结果，168例 CAG病人中 Ⅰ型 Hp组 83例， Ⅱ型 Hp组 39例， Hp阴性 46例；单纯胃窦萎缩病人， I型 Hp病人 G17低于 Ⅱ型和 Hp阴性组［3.61(2.57，5.04)pmol/L比 5.85(3.91，7.32)pmol/L，6.01(4.55， 8.39)pmol/L，P<0.05］；胃窦 +胃体萎缩病人， I型 Hp病人 PGⅠ［82.66(61.00，101.28)μg/L比 100.27(66.59，124.28)μg/L，98.04(70.22，121.43)μg/L］、 PRG［8.55(7.16，11.02)比 10.13(8.94，12.31)10.71(9.08，13.16)］低于 Ⅱ型和 Hp阴性组( P<0.05)；三组“改良 ABC”癌变风险分层差异有统计学意义( P<0.05)其中 Ⅰ型 Hp病，人高危层占比最高，达 33.74%；三组“木村 -竹本”分类法 “C型”“O型”的比例差异无统计学意义［18.72%(15/83，)比 23.07%(9/39)，13.04%(6/46)，P>0.05］；三组 OLGA分期差异有统计学意义(和P<0.05)，I型 Hp病人 Ⅲ期和 Ⅳ期共 19例，占比最高( 22.89%)但三组间对比显示， I型和 Ⅱ型 Hp病人间 OLGA分组差异无统计学意义( P>0.017)I型 Hp病人 OLGA高危组占比高于 Hp阴性，病人( P<0.017)。结论胃癌高发地区 CAG病人以 Ⅰ型 Hp感染多见，不同分型 Hp感，染的 CAG病人 PG、PGR、G17水平存在差异， Ⅰ型 Hp感染的 CAG病人癌变风险相对较高。 |
| 英文摘要: |
| Objective To analyze the differences in serum Helicobacter pylori (Hp)-antibody typing and cancer risk in patients with chronic atrophic gastritis (CAG) in areas with s high prevalence of gastric cancer.Methods A total of 168 patients with CAG who at-tended the Second People's Hospital of Hefei from December 2019 to January 2021 were enrolled in the study, and serum Hp antibodytyping (CagA, VacV, Ure) was detected by Western blotting and divided into a type Ⅰ Hp group, a type Ⅱ Hp group and a negativegroup. Enzyme-linked immunosorbent assay (ELISA) was used to detect gastric mucosal function [pepsinogen (PG) Ⅰ, PG Ⅱ, pepsino-gen ratio (PRG), gastrin 17 (G17)]. The "modified ABC method" was used to stratify the risk of cancer, and the extent of atrophy wasgraded according to the "Kimura-Takemoto" classification, and OLGA staging was performed according to the site and extent of atrophy. Results Among 168 CAG patients, 83 were in the type Ⅰ Hp group, 39 in the type Ⅱ Hp group and 46 in the Hp-negative group. In patients with simple sinus atrophy,type Ⅰ Hp patients had lower G17 than the type Ⅱ and Hp-negative groups [3.61 (2.57, 5.04) pmol/ L vs. 5.85 (3.91, 7.32) pmol/L, 6.01(4.55, 8.39) pmol/L, P<0.05]. In patients with gastric sinus + gastric body atrophy, PG Ⅰ [82.66 (61.00, 101.28) μg/L vs. 100.27 (66.59,124.28)μg/L, 98.04 (70.22, 121.43)μg/L], PRG [8.55 (7.16, 11.02) vs. 10.13 (8.94, 12.31), 10.71 (9.08, 13.16)] were lower than those in the type Ⅱ and Hp-negative groups(P<0.05). The difference between the three groups of "modi-fied ABC method" cancer risk stratification was statistically significant (P<0.05),with the highest percentage of type Ⅰ Hp patients in the high-risk stratum (33.74%).The differences in the proportions of "C" and "O" types in the three groups according to the "Kimura-Takemoto" classification were not statistically significant [18.72% (15/83) vs. 23.07% (9/39), 13.04% (6/46),P>0.05].The difference in OLGA stage between the three groups was statistically significant (P<0.05),and the highest percentage (22.89%) was found in 19 casesof stage Ⅲ and Ⅳ Hp patients with type Ⅰ Hp, but the comparison results between the three groups showed that the difference in OL-GA grouping between type Ⅰ and type Ⅱ Hp patients was not statistically significant (P>0.017), and the percentage of OLGA high-risk patients was higher in type Ⅰ Hp patients than in Hp-negative patients (P<0.017).Conclusion Patients with CAG in regions with highincidence of gastric cancer are more frequently infected with type Ⅰ Hp.The levels of PG, PGR and G17 in CAG patients with differentsubtypes of Hp infection differed, and the risk of cancer was relatively higher in CAG patients with type Ⅰ Hp infection. |
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