台湾地区胃癌患者中幽门螺杆菌cagA、iceA和vacA基因型
Helicobacter pylori cagA, iceA and vacA genotypes in patients with gastric cancer in Taiwan.
作者信息
Lin Hwai-Jeng, Perng Chin-Lin, Lo Wen-Ching, Wu Chew-Wun, Tseng Guan-Ying, Li Anna-Fen-Yau, Sun I-Chen, Ou Yueh-Hsing
机构信息
Division of Gastroenterology, Department of Medicine, VGH-TAIPEI, Shih-Pai Rd, Sec 2, Taipei, 11217, Taiwan, China.
出版信息
World J Gastroenterol. 2004 Sep 1;10(17):2493-7. doi: 10.3748/wjg.v10.i17.2493.
AIM
Helicobacter pylori (H pylori ) has been linked to chronic gastritis, peptic ulcer, gastric cancer and MALT-lymphoma. The link of genotypes of H pylori to gastric cancer remains controversial. The aim of this study was to investigate the H pylori vacA alleles, cagA and iceA in patients with gastric cancer in Taiwan.
METHODS
Patients with gastric cancer, peptic ulcer and chronic gastritis were enrolled in this study. We obtained biopsy specimens from the stomach at least 2 cm away from the tumor margin in patients with gastric cancer, and from the antrum of stomach in patients with peptic ulcer or chronic gastritis. DNA extraction and polymerase chain reaction were used to detect the presence or absence of cagA and to assess the polymorphism of vacA and iceA.
RESULTS
A total of 168 patients (gastric ulcer: 77, duodenal ulcer: 66, and chronic gastritis: 25) were found to have positive PCR results of the biopsy specimens from patients with peptic ulcer and chronic gastritis. We found positive cagA (139/168, 83%), m2 (84/168, 50%) and iceA1 (125/168, 74%) strains in the majority of patients. In patients with gastric cancer, the vacA s1a and s1c subtypes were less commonly found than those in non-cancer patients (35/66 vs 127/168, P = 0.0001 for s1a and 13/66 vs 93/168, P<0.0001 for s1c). In the middle region, the m1T strain in patients with gastric cancer was more than that of non-cancer patients (23/66 vs 33/168, P = 0.02).
CONCLUSION
In Taiwan, H pylori with positive vacA s1a, cagA and iceA1 strains are found in the majority of patients with gastric cancer or non-cancer patients. In patients with gastric cancer, the vacA s1a and s1c subtypes are less and m1T is more than in patients with peptic ulcer and chronic gastritis.
目的
幽门螺杆菌（H pylori）与慢性胃炎、消化性溃疡、胃癌及黏膜相关淋巴组织淋巴瘤有关。幽门螺杆菌基因型与胃癌的关联仍存在争议。本研究旨在调查台湾地区胃癌患者中的幽门螺杆菌vacA等位基因、cagA和iceA。
方法
本研究纳入了胃癌、消化性溃疡和慢性胃炎患者。对于胃癌患者，我们从距肿瘤边缘至少2 cm的胃组织获取活检标本；对于消化性溃疡或慢性胃炎患者，从胃窦部获取活检标本。采用DNA提取和聚合酶链反应检测cagA的有无，并评估vacA和iceA的多态性。
结果
共168例患者（胃溃疡77例、十二指肠溃疡66例、慢性胃炎25例）的消化性溃疡和慢性胃炎患者活检标本PCR结果呈阳性。我们发现大多数患者中cagA阳性（139/168，83%）、m2阳性（84/168，50%）和iceA1阳性（125/168，74%）菌株。在胃癌患者中，vacA s1a和s1c亚型的发现频率低于非癌症患者（s1a：35/66 vs 127/168，P = 0.0001；s1c：13/66 vs 93/168，P<0.0001）。在中部地区，胃癌患者中的m1T菌株多于非癌症患者（23/66 vs 33/168，P = 0.02）。
结论
在台湾地区，大多数胃癌患者或非癌症患者中幽门螺杆菌vacA s**1a、cagA和iceA1菌株呈阳性。与消化性溃疡和慢性胃炎患者相比，胃癌患者中vacA s1a和s1c亚型较少，m1T较多。
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