Taguchi Ayumu, Ohmiya Naoki, Itoh Akihiro, Hirooka Yoshiki, Niwa Yasumasa, Mori Naoyoshi, Goto Hidemi
Division of Gastroenterology, Department of Therapeutic Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Gastroenterol Hepatol. 2006 Mar;21(3):545-51. doi: 10.1111/j.1440-1746.2005.03983.x.
Infection with Helicobacter pylori (Hp) has been linked to atrophic gastritis, an inflammatory precursor of non-cardia gastric carcinoma. Mutations in the p53 gene are one of the most frequent genetic alterations in gastric carcinoma. In a subgroup of atrophic gastritis, antiparietal cell antibody (APCA) has been detected. This study was aimed to clarify the role of APCA in the progression of atrophic gastritis and gastric carcinogenesis, and to determine the relationship of the severity of atrophic gastritis to gastric carcinoma and to p53 mutations.
In 494 control subjects and 284 gastric carcinoma patients, serum APCA was evaluated and all subjects and patients were classified into four groups using serologic markers (anti-Hp IgG antibody and pepsinogen (PG) test: positive; PG I < 70 microg/L and PG I/II ratio < 3.0) as follows: A, HP- PG-; B, HP+ PG-; C, HP+ PG+ and D, HP- PG+. p53 mutations were analyzed in 174 of 284 patients.
Antiparietal cell antibody seropositivity increased from group B to D, however, no difference in its positivity was found between controls and patients. The incidence of gastric carcinoma increased from A to D, especially the intestinal subtype. The frequency of p53 gene mutations was higher in PG+ than in PG- gastric carcinoma.
Antiparietal cell antibody seropositivity is involved in the progression of a subgroup of atrophic gastritis, but not associated with gastric carcinogenesis. Severe atrophic gastritis is associated with susceptibility to gastric carcinoma, especially the intestinal subtype, and p53 mutations.
幽门螺杆菌（Hp）感染与萎缩性胃炎相关，萎缩性胃炎是非贲门胃癌的炎症前驱病变。p53基因突变是胃癌中最常见的基因改变之一。在一部分萎缩性胃炎患者中，已检测到抗壁细胞抗体（APCA）。本研究旨在阐明APCA在萎缩性胃炎进展和胃癌发生过程中的作用，并确定萎缩性胃炎严重程度与胃癌及p53基因突变之间的关系。
对494名对照者和284名胃癌患者检测血清APCA，并使用血清学标志物（抗Hp IgG抗体和胃蛋白酶原（PG）检测：阳性；PG I<70μg/L且PG I/II比值<3.0）将所有受试者和患者分为四组：A组，Hp-PG-；B组，Hp+PG-；C组，Hp+PG+；D组，Hp-PG+。对284例患者中的174例进行p53基因突变分析。
抗壁细胞抗体血清阳性率从B组到D组升高，但对照者和患者之间其阳性率无差异。胃癌发病率从A组到D组升高，尤其是肠型。PG+胃癌中p53基因突变频率高于PG-胃癌。
抗壁细胞抗体血清阳性与一部分萎缩性胃炎的进展有关，但与胃癌发生无关。严重萎缩性胃炎与胃癌易感性相关，尤其是肠型，且与p53基因突变有关。
