Relation between Helicobacter pylori cagA status and risk of peptic ulcer disease
Relation between Helicobacter pylori cagA status and risk of peptic ulcer disease
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DOI：
10.1093/aje/155.11.1054
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发表时间：
2002-06-01
影响因子：
5
通讯作者：
Blaser, MJ
中科院分区：
文献类型：
--
作者：
Nomura, AMY;Pérez-Pérez, GI;Blaser, MJ
尽管任何幽门螺杆菌菌株的定植与消化性溃疡有关，但尚不确定cagA(+)或cagA(-)菌株的风险更大，这两种菌株的生物学特性不同。一项嵌套式病例对照研究基于1967年至1970年在夏威夷瓦胡岛接受检查的5443名日裔美国男性。共有150名患有胃溃疡的男性，65名患有十二指肠溃疡，14名同时患有这两种疾病。作者将229例患者与229例人群对照，用酶联免疫吸附试验检测其血清中抗幽门螺杆菌免疫球蛋白G抗体和抗幽门螺杆菌cagA产物的免疫球蛋白G抗体。幽门螺杆菌阳性者患胃溃疡的优势比为4.0(95%可信区间：1.9，8.5)，患十二指肠溃疡的优势比为2.5(95%CI：0.8，7.4)。CagA阳性者胃溃疡的优势比为1.4(95%CI：0.9，2.4)，十二指肠溃疡的优势比为2.6(95%CI：1.1，5.8)。Hp和CagA同时阳性的患者患胃溃疡的优势比为4.4(95%CI：1.8，10.5)，患十二指肠溃疡的优势比为5.8(95%CI：1.1，30.0)。结果表明，幽门螺杆菌CAG(+)菌株定植的风险高于CAG(-)幽门螺杆菌菌株对胃溃疡和十二指肠溃疡的风险。
Although colonization with any Helicobacter pylori strain is associated with peptic ulcer, it is uncertain whether the risk is greater with cagA(+) or cagA(-) strains, which differ in their biology. A nested case-control study was done, based on a cohort of 5,443 Japanese-American men examined on the Hawaiian island of Oahu from 1967 to 1970. A total of 150 men with gastric ulcer, 65 with duodenal ulcer, and 14 with both diseases were identified. The authors matched the 229 cases with 229 population controls and tested their serum for immunoglobulin G antibodies to H. pylori and immunoglobulin G antibodies to the cagA product of H. pylori using enzyme-linked immunosorbent assays. Persons with H. pylori positivity had an odds ratio of 4.0 (95% confidence interval (CI): 1.9, 8.5) for gastric ulcer and 2.5 (95% CI: 0.8, 7.4) for duodenal ulcer. For CagA positivity, the odds ratios were 1.4 (95% CI: 0.9, 2.4) for gastric ulcer and 2.6 (95% CI: 1.1, 5.8) for duodenal ulcer. Subjects who were seropositive for both H. pylori and CagA had an odds ratio of 4.4 (95% CI: 1.8, 10.5) for gastric ulcer and 5.8 (95% CI: 1.1, 30.0) for duodenal ulcer. The results suggest that colonization with a cag(+) H. pylori strain elevates the risk beyond that of a cag(-) H. pylori strain for both gastric and duodenal ulcers.