Miehlke S, Kirsch C, Agha-Amiri K, Günther T, Lehn N, Malfertheiner P, Stolte M, Ehninger G, Bayerdörffer E
Medical Department I, Technical University Hospital Dresden, Dresden, Germany.
Int J Cancer. 2000 Aug 1;87(3):322-7.
The H. pylori vacuolating cytotoxin encoded by vacA and the cytotoxin-associated protein encoded by cagA are considered to be important virulence determinants that have been implicated in the development of peptic ulcers and gastric carcinoma. However, conflicting results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions.
To determine the frequency of vacA genotypes, vacuolating cytotoxin activity, and cagA in H. pylori isolates obtained from patients with gastric cancer in Germany.
H. pylori isolates were obtained from 34 patients with gastric cancer and from 35 subjects with asymptomatic H. pylori gastritis. vacA genotypes and cagA were identified by PCR. Cytotoxic activity was determined by HeLa cell assays. Gastritis was assessed according to the updated Sydney System.
The H. pylori vacA s1,m1 genotype was significantly more frequent in patients with gastric cancer (24/34, 70.6%) as compared with controls (12/35, 34. 3%) (p = 0.005). Cytotoxic activity was detected in 24 (70.6%) and 15 (42.9%) H. pylori isolates from gastric cancer patients and controls, respectively (p = 0.03). The cagA gene was identified in 30 (88.2%) and 21 (60%) H. pylori isolates in the respective groups (p = 0.01).
Our study suggests a significant association between the H. pylori vacA s1,m1 genotype, cytotoxic activity, cagA, and gastric cancer. Detection of H. pylori possessing these virulence determinants may help to identify patients being at an increased risk to develop gastric cancer in our population.
由vacA编码的幽门螺杆菌空泡毒素和由cagA编码的细胞毒素相关蛋白被认为是重要的毒力决定因素，与消化性溃疡和胃癌的发生有关。然而，不同地理区域报道了这些毒力因子与临床疾病之间关联的相互矛盾的结果。
确定从德国胃癌患者中分离出的幽门螺杆菌菌株中vacA基因型、空泡毒素活性和cagA的频率。
从34例胃癌患者和35例无症状幽门螺杆菌胃炎患者中分离幽门螺杆菌菌株。通过PCR鉴定vacA基因型和cagA。通过HeLa细胞试验测定细胞毒性活性。根据更新的悉尼系统评估胃炎。
与对照组（12/35，34.3%）相比，胃癌患者中幽门螺杆菌vacA s1,m1基因型明显更常见（24/34，70.6%）（p = 0.005）。分别在24例（70.6%）和15例（42.9%）来自胃癌患者和对照组的幽门螺杆菌菌株中检测到细胞毒性活性（p = 0.03）。在相应组中，分别在30例（88.2%）和21例（60%）幽门螺杆菌菌株中鉴定出cagA基因（p = 0.01）。
我们的研究表明幽门螺杆菌vacA s1,m1基因型、细胞毒性活性、cagA与胃癌之间存在显著关联。检测具有这些毒力决定因素的幽门螺杆菌可能有助于识别我们人群中患胃癌风险增加的患者。
