Helicobacter pylori CagA status associated with gastric cancer incidence rate variability in Costa Rican regions
Helicobacter pylori CagA status associated with gastric cancer incidence rate variability in Costa Rican regions
复制标题
DOI：
10.1007/s00535-006-1812-3
复制
发表时间：
2006-06-01
影响因子：
6.3
通讯作者：
Araki, Keijiro
中科院分区：
文献类型：
--
作者：
Con, Sergio A.;Valerin, Ana L.;Araki, Keijiro
我们评估了哥斯达黎加地区的几个胃癌危险因素，尽管这个国家的面积很小，但胃癌发病率存在差异。总共180名消化不良患者根据他们所在哥斯达黎加地区的胃癌发病率(GCI)被分为两组：A组，GCI率高(n=91)，B组，GCI率低(n=89)。用快速尿素酶试验、革兰氏染色和组织学观察检测幽门螺杆菌感染情况。取胃窦和胃体标本，通过组织学检查评估炎症分级、胃炎形态、胃萎缩和肠化生。用抗原特异性酶联免疫吸附试验检测血清CagA抗体，发现A组和B组之间Hp感染率(73%和63%)无显著差异，但A组(79%)高于B组(54%)[P=0.02；优势比(OR)，2.68]。在60岁以下患者中，A组血清CagA抗体阳性率(81%)高于B组(49%)(P<；0.01；OR，4.50)。血清CagA抗体阳性患者的胃小体主导性胃炎、萎缩性胃炎和中重度中性粒细胞浸润的发生率高于CagA抗体阴性患者(P分别为0.003、0.04和0.002)。携带cagA基因的幽门螺杆菌感染与胃萎缩等严重胃损害的发生有关，并可能影响哥斯达黎加不同地区胃黏膜损害程度的差异。
We evaluated several risk factors for gastric cancer in Costa Rican regions having contrasting gastric cancer incidence rates, despite the small dimensions of the country.A total of 180 dyspeptic patients were classified into two groups according to the gastric cancer incidence (GCI) rate in their Costa Rican region: group A, with a high GCI rate (n = 91) and group B, with a low GCI rate (n = 89). Helicobacter pylori infection was detected by rapid urease test, Gram staining, and histological observation. Antral and corpus specimens were obtained to assess the grade of inflammation, topography of gastritis, gastric atrophy, and intestinal metaplasia by histological examination. Serum CagA antibody was measured by an antigen-specific enzyme-linked immunosorbent assay.There was no significant difference in H. pylori prevalence between groups A (73%) and B (63%); however, serum CagA antibody was more frequently detected in group A (79%) than in group B (54%) [P = 0.02; odds ratio (OR), 2.68]. Among patients under 60 years of age, serum CagA antibody was even more frequently detected in group A (81%) than in group B (49%) (P < 0.01; OR, 4.50). The prevalence of corpus-predominant gastritis, atrophic gastritis, and moderate/severe grades of neutrophilic infiltration was higher in serum CagA antibody-positive patients than in CagA antibody-negative patients (P = 0.003, 0.04, and 0.002, respectively).Infection with H. pylori possessing the cagA gene is associated with the development of severe gastric damage such as gastric atrophy, leading to gastric cancer, and probably influences the differences in GCI between Costa Rican regions.