感染CagA阳性幽门螺杆菌的患者发生萎缩性胃炎的风险增加。

Increased risk of developing atrophic gastritis in patients infected with CagA+ Helicobacter pylori.

作者信息

Sande N, Nikulin M, Nilsson I, Wadström T, Laxén F, Härkönen M, Suovaniemi O, Sipponen P

机构信息

Dept. of Clinical Chemistry, Helsinki University Central Hospital, Finland.

出版信息

Scand J Gastroenterol. 2001 Sep;36(9):928-33. doi: 10.1080/003655201750305431.

DOI:10.1080/003655201750305431

PMID:11521982

Abstract

BACKGROUND

To clarify the possible role of CagA positive (CagA+) Helicobacter pylori strains in the development of atrophic gastritis, the prevalence of antibodies to H. pylori and CagA (120 kD protein) was studied among subjects with atrophic and non-atrophic gastritis.

METHODS

The study population was randomly selected among 12,252 Finnish men who were screened for atrophic corpus gastritis with serum pepsinogen I-assay (S-PGI). S-PGI level was used as a selection criterion. Group A consisted of 295 subjects with S-PGI <25 microg/l (low), group B of 320 subjects with S-PGI 25-100 microg/l (normal) and group C of 338 subjects with S-PGI >100 microg/l (high). Antibodies to H. pylori were measured with EIA and immunoblot analysis and antibodies to CagA with immunoblot analysis. Endoscopical and histological examinations were performed for 203 patients from group A.

RESULTS

The prevalence of antibodies to H. pylori was significantly lower in group B than in groups A or C (P < 0.0001, chi-squared test). There was a significant association between the prevalence of antibodies to CagA and the lowered level of S-PGI (P < 0.0001, Jonckheere-Terpstra trend test). There was also a linear decrease in the prevalence of antibodies to CagA as the atrophic corpus gastritis became more severe (P < 0.0001, linear-by-linear trend test).

CONCLUSION

The presence of antibodies to CagA seems to be associated with development of atrophic corpus gastritis.

摘要

背景

为阐明细胞毒素相关基因A阳性（CagA+）幽门螺杆菌菌株在萎缩性胃炎发生发展中的可能作用，我们研究了萎缩性胃炎和非萎缩性胃炎患者中幽门螺杆菌及CagA（120 kD蛋白）抗体的流行情况。

方法

在12252名接受血清胃蛋白酶原I检测（S-PGI）以筛查胃体萎缩性胃炎的芬兰男性中随机选取研究对象。S-PGI水平用作选择标准。A组由295名S-PGI<25μg/L（低水平）的受试者组成，B组由320名S-PGI为25-100μg/L（正常水平）的受试者组成，C组由338名S-PGI>100μg/L（高水平）的受试者组成。采用酶免疫分析和免疫印迹分析检测幽门螺杆菌抗体，采用免疫印迹分析检测CagA抗体。对A组的203名患者进行了内镜和组织学检查。

结果

B组幽门螺杆菌抗体的流行率显著低于A组或C组（P<0.0001，卡方检验）。CagA抗体的流行率与S-PGI水平降低之间存在显著关联（P<0.0001，Jonckheere-Terpstra趋势检验）。随着胃体萎缩性胃炎加重，CagA抗体的流行率也呈线性下降（P<0.0001，线性-线性趋势检验）。