Department of Molecular Pathology, Oita University, Yufu City, Japan.
BMC Gastroenterol. 2010 Sep 30;10:114. doi: 10.1186/1471-230X-10-114.
The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail.
Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing.
Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh.
H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.
据报道，越南的幽门螺杆菌感染率很高，但幽门螺杆菌相关的胃十二指肠疾病谱尚未得到系统研究。此外，尽管种族和饮食相似，但北部城市河内的胃癌标准化发病率高于南部城市胡志明市，但这种现象的原因尚不清楚。越南幽门螺杆菌的毒力也没有得到详细研究。
随机招募接受食管胃十二指肠镜检查的个体。幽门螺杆菌感染状态根据培养、组织学、免疫组织化学、快速尿液检测和血清 ELISA 的综合结果确定。消化性溃疡（PU）和胃食管反流病通过内镜诊断，慢性胃炎通过组织学确定。通过 PCR 和测序研究幽门螺杆菌毒力因子。
在所检查的患者中，65.6%感染了幽门螺杆菌。40 岁以上人群的感染率明显高于≤40 岁人群。所有感染幽门螺杆菌的个体均存在慢性胃炎，其中 83.1%有活动性胃炎，85.3%和 14.7%分别有萎缩和肠化生。感染患者中有 21%存在 PU，而非感染患者的发病率非常低。PU 在河内的患病率明显高于胡志明市。在河内分离的幽门螺杆菌中，已被确定为越南 PU 独立危险因素的 vacA m1 的流行率明显高于胡志明市。
幽门螺杆菌感染在越南很常见，与 PU、活动性胃炎、萎缩和肠化生密切相关。vacA m1 与 PU 风险增加相关，可能导致河内和胡志明市之间 PU 和胃癌患病率的差异。
