Progression of atrophic gastritis and intestinal metaplasia drives Helicobacter pylori out of the gastric mucosa
Progression of atrophic gastritis and intestinal metaplasia drives Helicobacter pylori out of the gastric mucosa
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DOI：
10.1007/s10620-006-9276-0
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发表时间：
2006-12-01
影响因子：
3.1
通讯作者：
Song, In Sung
中科院分区：
文献类型：
--
作者：
Kang, Hae Yeon;Kim, Nayoung;Song, In Sung
本研究旨在评估抗H。幽门螺杆菌检测、组织学检查、胃窦和胃体培养均为阴性时，幽门螺杆菌抗体阳性，并找出萎缩性胃炎和肠化生(IM)与幽门螺杆菌的恶性关系影响较大的特定病种。436例未接受根除治疗的患者(对照组84例，十二指肠溃疡69例，良性胃溃疡96例，异型增生43例，胃癌144例)根据幽门螺杆菌检测结果分为三组：幽门螺杆菌检测或组织学幽门螺杆菌阳性组(A组，294例)，单纯抗H.幽门螺杆菌Ig G阳性组(B组)62例，抗H.幽门螺杆菌抗体阴性组(C组，80例)。根据最新的悉尼系统分类比较中性粒细胞和单核细胞浸润、萎缩性胃炎和IM的分级。B组胃窦部萎缩性胃炎及肠化程度明显高于A、C两组，按疾病转归分组时，B组仅癌或异型增生患者的胃体IM分级明显高于B组。幽门螺杆菌侵袭性试验全部阴性的幽门螺杆菌抗体阳性代表过去感染过幽门螺杆菌，而不是假阴性，特别是在不典型增生和胃癌的情况下。
This study was performed to evaluate the implication of anti-H. pylori IgG positivity when CLOtest, histological test, and culture in the antrum and body are all negative, and to find out the specific disease category that is more affected by the hostile relationship of atrophic gastritis and intestinal metaplasia (IM) with H. pylori. Four hundred thirty-six patients (84 controls, 69 with duodenal ulcer, 96 with benign gastric ulcer, 43 with dysplasia, 144 with gastric cancer), who had not received any eradication therapy, were divided into three groups according to H. pylori test: CLOtest or histological H. pylori-positive group (group A; 294 cases), only anti-H. pylori IgG-positive group (group B; 62 cases), and anti-H. pylori IgG-negative group (group C; 80 cases). The grade of neutrophil and monocyte infiltration, atrophic gastritis, and IM was compared according to the updated Sydney system classification. Neutrophil and monocyte infiltrations were signiticantly severe in the group A. In contrast, the grade of atrophic gastritis and IM in the antrum was significantly higher in group B than the other two groups, A or C. When patients were divided according to the disease outcome in each group, the grade of IM in the body was statistically higher only in the patients with cancer or dysplasia in group B. These results suggest that anti-H. pylori IgG positivity with all negative invasive H. pylori tests represents past infection with H. pylori rather than a false negative, especially in the case of dysplasia and gastric cancer.