Ławniczak MaŁgorzata, Starzyńska Teresa
Klinika Gastroenterologii Pomorskiej Akademii Medycznej w Szczecinie.
Pol Merkur Lekarski. 2002 Sep;13(75):216-20.
The aim of the study was to evaluate the role of Helicobacter pylori CagA(+) infection in gastric cancer.
475 patients were included into the study (270 gastric cancer patients and 205 control subjects). Helicobacter pylori CagA status was determined by enzyme-linked immunoabsorbent assay (ELISA). The frequency of H. pylori CagA infection in gastric cancer patients and control group was compared. The relationship between presence of anti-H. pylori CagA antibodies and selected clinical and pathomorphological parameters was analysed.
Gastric cancer patients and controls had the same prevalence of H. pylori CagA antibodies (54.4 vs 52.5%; p = 0.078). The persons with H. pylori CagA(+) and CagA(-) were at the same risk for developing gastric cancer (OR = 1.08; 95%CI = 0.66-1.49). However subgroup analysis showed that the risk of gastric cancer development in H. pylori CagA(+) depended on age being 2 times higher for young people (15-40 years) (OR = 2.0; 95% CI = 0-4.25) and four times higher for those under the age of 30 years (OR = 4.0; 95%CI = 0-15.9). There was a positive relationship between H. pylori CagA(+) infection and age (p = 0.043). H. pylori CagA(+) infection was independent of sex, family history of cancers, duration of symptoms, ABO blood group, tumour site, stage, histology and p53 accumulation in cancer gastric tissue.
Our study shows that H. pylori CagA(+) infection increases the risk for developing gastric cancer in young persons and does not protect the host against cardia cancer. The results suggest also that infection by H. pylori CagA(+) in gastric cancer has no influence on p53 gene mutation development.
本研究旨在评估幽门螺杆菌CagA(+)感染在胃癌中的作用。
475例患者纳入研究(270例胃癌患者和205例对照者)。通过酶联免疫吸附测定(ELISA)确定幽门螺杆菌CagA状态。比较胃癌患者和对照组中幽门螺杆菌CagA感染的频率。分析抗幽门螺杆菌CagA抗体的存在与选定的临床和病理形态学参数之间的关系。
胃癌患者和对照者中幽门螺杆菌CagA抗体的患病率相同(54.4%对52.5%;p = 0.078)。幽门螺杆菌CagA(+)和CagA(-)的人患胃癌的风险相同(OR = 1.08;95%CI = 0.66 - 1.49)。然而,亚组分析显示,幽门螺杆菌CagA(+)患者患胃癌的风险取决于年龄,年轻人(15 - 40岁)患癌风险高2倍(OR = 2.0;95%CI = 0 - 4.25),30岁以下者患癌风险高4倍(OR = 4.0;95%CI = 0 - 15.9)。幽门螺杆菌CagA(+)感染与年龄呈正相关(p = 0.043)。幽门螺杆菌CagA(+)感染与性别、癌症家族史、症状持续时间、ABO血型、肿瘤部位、分期、组织学以及胃癌组织中p53积聚无关。
我们的研究表明,幽门螺杆菌CagA(+)感染增加了年轻人患胃癌的风险,并且不能保护宿主免受贲门癌的侵害。结果还表明,胃癌中幽门螺杆菌CagA(+)感染对p53基因突变的发生没有影响。