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幽门螺杆菌与胃癌的关联。

Association of Helicobacter pylori with carcinoma of stomach.

作者信息

Arif Muhammad, Syed Serajuddaula

机构信息

Department of Pathology, Sindh Medical College, Karachi.

出版信息

J Pak Med Assoc. 2007 Jul;57(7):337-41.

PMID:17867254
Abstract

OBJECTIVE

To note the association of Helicobacter pylori in patients having carcinoma of stomach.

METHODS

A descriptive study was carried out at the Department of Histopathology, Ziauddin Medical University, Karachi from April 1992 to May 1998. Histological evaluation of 50 cases of carcinoma of stomach was compared with 50 cases each of chronic gastritis and histological normal gastric mucosa. Only those cases of carcinoma of stomach were included that contained sufficient non-neoplastic mucosa in addition to tumour tissue. Three glass slides with serial sections of each case of carcinoma of stomach, chronic gastritis and normal gastric mucosa were freshly cut and stained with H&E, PAS and Giemsa stains. All slides were examined by light microscopy.

RESULTS

Helicobacter pylori were identified in 35 cases (70%) of carcinoma of stomach, in 42 cases (84%) of chronic gastritis, and in 12 cases (24%) of normal gastric mucosa. The presence of H. pylori in cases of carcinoma of stomach and chronic gastritis was highly significant (P < 0.001) as compared to normal gastric mucosa. Chronic gastritis was observed in the non-neoplastic mucosa in 48 cases (96%) with carcinoma of stomach. Of 50 cases with carcinoma of the stomach, intestinal type of carcinoma was found in 30 cases (70%), and diffuse type in 15 cases (30%). No significant difference was noted in the prevalence of H. pylori between intestinal type (69%) and diffuse type (71%) gastric carcinoma. Significant Helicobacter pylori associated chronic gastritis was observed in intestinal type (94%) and diffuse type (100%) of gastric carcinoma. The prevalence of H. pylori was insignificant in the presence or absence of mucosal atrophy and intestinal metaplasia in both types of gastric carcinoma.

CONCLUSION

A significant number of H. pylori were found in patients of carcinoma of stomach. Both intestinal and diffuse types of gastric carcinoma showed strong association with H. pylori. Chronic gastritis appears to be the background lesion while atrophy and intestinal metaplasia indicate long term infection.

摘要

目的

观察幽门螺杆菌与胃癌患者之间的关联。

方法

1992年4月至1998年5月在卡拉奇齐亚丁医科大学组织病理学系开展了一项描述性研究。对50例胃癌病例的组织学评估与50例慢性胃炎病例以及50例组织学正常的胃黏膜病例进行了比较。仅纳入那些除肿瘤组织外还含有足够非肿瘤性黏膜的胃癌病例。对每例胃癌、慢性胃炎和正常胃黏膜病例的连续切片制作三张玻片,新鲜切片后用苏木精-伊红染色、过碘酸-雪夫染色和吉姆萨染色。所有玻片均通过光学显微镜检查。

结果

在35例(70%)胃癌病例、42例(84%)慢性胃炎病例和12例(24%)正常胃黏膜病例中发现了幽门螺杆菌。与正常胃黏膜相比,胃癌病例和慢性胃炎病例中幽门螺杆菌的存在具有高度显著性(P < 0.001)。在48例(96%)胃癌病例的非肿瘤性黏膜中观察到慢性胃炎。在50例胃癌病例中,发现肠型癌30例(70%),弥漫型癌15例(30%)。肠型(69%)和弥漫型(71%)胃癌中幽门螺杆菌的患病率无显著差异。在肠型(94%)和弥漫型(100%)胃癌中均观察到与幽门螺杆菌显著相关的慢性胃炎。在两种类型的胃癌中,无论有无黏膜萎缩和肠化生,幽门螺杆菌的患病率均无显著差异。

结论

在胃癌患者中发现了大量幽门螺杆菌。肠型和弥漫型胃癌均与幽门螺杆菌有很强的关联。慢性胃炎似乎是背景病变,而萎缩和肠化生表明长期感染。

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