International Agency for Research on Cancer, Lyon, France.
DDL Diagnostic Laboratory, Voorburg, The Netherlands.
Int J Cancer. 2010 Apr 15;126(8):1992-1996. doi: 10.1002/ijc.24898.
Using data from a Venezuelan cohort of 1,948 adults, the gastric detection of Helicobacter pylori (H. pylori) by polymerase chain reaction (PCR) of the vacA gene in 1 antral biopsy was compared to the detection of H. pylori by histopathology (hematoxylin-eosin and Giemsa staining) in 5 biopsies (antrum and corpus). Overall, H. pylori was detected in 85% and 95% of the subjects by PCR and histopathology, respectively. When results were analyzed by severity of precancerous lesions, PCR on 1 biopsy detected the bacteria less often than histopathology on 5 biopsies in subjects with normal gastric mucosa and non-atrophic gastritis. However, in subjects with the most severe lesions (intestinal metaplasia type III and dysplasia), PCR on 1 biopsy detected H. pylori as often as histopathology on 5 biopsies, and significantly more often than histopathology on a single biopsy. In conclusion, these findings confirm that histopathology on 5 biopsies is an accurate tool for H. pylori detection in most subjects, compared to the PCR method on 1 biopsy. Nevertheless, the elevated sensitivity of PCR for detecting the bacteria in advanced precancerous lesions, and the possibility to use PCR to distinguish between cagA-positive and cagA-negative strains, makes the PCR technique especially useful in studies of stomach cancer.
利用来自委内瑞拉的 1948 名成年人队列的数据，通过聚合酶链反应（PCR）检测胃黏膜活检标本中 vacA 基因的幽门螺杆菌（H. pylori），与 5 个活检标本（胃窦和胃体）的组织病理学（苏木精-伊红和吉姆萨染色）检测 H. pylori 进行了比较。总体而言，PCR 和组织病理学分别在 85%和 95%的受试者中检测到 H. pylori。当根据癌前病变的严重程度进行分析时，在胃黏膜正常和非萎缩性胃炎的受试者中，1 个活检标本的 PCR 检测细菌的频率低于 5 个活检标本的组织病理学。然而，在病变最严重的受试者中（III 型肠上皮化生和发育不良），1 个活检标本的 PCR 检测到 H. pylori 的频率与 5 个活检标本的组织病理学相同，并且明显高于单个活检标本的组织病理学。总之，这些发现证实，与 1 个活检标本的 PCR 方法相比，5 个活检标本的组织病理学是检测大多数受试者 H. pylori 的准确工具。然而，PCR 检测细菌在高级癌前病变中的敏感性提高，以及使用 PCR 区分 cagA 阳性和 cagA 阴性菌株的可能性，使得 PCR 技术在胃癌研究中特别有用。
