泰国幽门螺杆菌感染：一项关于细胞毒素相关基因A（CagA）表型的全国性研究。
Helicobacter pylori Infection in Thailand: A Nationwide Study of the CagA Phenotype.
作者信息
Uchida Tomohisa, Miftahussurur Muhammad, Pittayanon Rapat, Vilaichone Ratha-Korn, Wisedopas Naruemon, Ratanachu-Ek Thawee, Kishida Tetsuko, Moriyama Masatsugu, Yamaoka Yoshio, Mahachai Varocha
机构信息
Department of Molecular Pathology, Oita University Faculty of Medicine, Hasama-machi, Yufu-City, Oita, Japan.
Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Hasama-machi, Yufu-City, Oita, Japan; Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia.
出版信息
PLoS One. 2015 Sep 10;10(9):e0136775. doi: 10.1371/journal.pone.0136775. eCollection 2015.
BACKGROUND
The risk to develop gastric cancer in Thailand is relatively low among Asian countries. In addition, the age-standardized incidence rate (ASR) of gastric cancer in Thailand varies with geographical distribution; the ASR in the North region is 3.5 times higher than that in the South region. We hypothesized that the prevalence of H. pylori infection and diversity of CagA phenotype contributes to the variety of gastric cancer risk in various regions of Thailand.
METHODS
We conducted a nationwide survey within Thailand. We determined H. pylori infection prevalence by detecting H. pylori, using histochemical and immunohistochemical methods. The anti-CagA antibody and anti-East-Asian type CagA antibody (α-EAS Ab), which showed high accuracy in several East Asian countries, were used to determine CagA phenotype.
RESULTS
Among 1,546 patients from four regions, including 17 provinces, the overall prevalence of H. pylori infection was 45.9% (710/1,546). Mirroring the prevalence of H. pylori infection, histological scores were the lowest in the South region. Of the 710 H. pylori-positive patients, 93.2% (662) were immunoreactive with the anti-CagA antibody. CagA-negative strain prevalence in the South region was significantly higher than that in other regions (17.9%; 5/28; p < 0.05). Overall, only 77 patients (11.6%) were immunoreactive with the α-EAS Ab. There were no differences in the α-EAS Ab immunoreactive rate across geographical regions.
CONCLUSIONS
This is the first study using immunohistochemistry to confirm H. pylori infections across different regions in Thailand. The prevalence of East-Asian type CagA H. pylori in Thailand was low. The low incidence of gastric cancer in Thailand may be attributed to the low prevalence of precancerous lesions. The low incidence of gastric cancer in the South region might be associated with the lower prevalence of H. pylori infection, precancerous lesions, and CagA-positive H. pylori strains, compared with that in the other regions.
背景
在亚洲国家中，泰国患胃癌的风险相对较低。此外，泰国胃癌的年龄标准化发病率（ASR）因地理分布而异；北部地区的ASR比南部地区高3.5倍。我们推测，幽门螺杆菌感染的流行率和CagA表型的多样性导致了泰国不同地区胃癌风险的差异。
方法
我们在泰国开展了一项全国性调查。我们采用组织化学和免疫组织化学方法检测幽门螺杆菌，以确定幽门螺杆菌感染的流行率。在几个东亚国家显示出高准确性的抗CagA抗体和抗东亚型CagA抗体（α-EAS Ab）被用于确定CagA表型。
结果
在来自包括17个省份的四个地区的1546名患者中，幽门螺杆菌感染的总体流行率为45.9%（710/1546）。与幽门螺杆菌感染的流行率一致，组织学评分在南部地区最低。在710名幽门螺杆菌阳性患者中，93.2%（662）对抗CagA抗体呈免疫反应。南部地区CagA阴性菌株的流行率显著高于其他地区（17.9%；5/28；p<0.05）。总体而言，只有77名患者（11.6%）对α-EAS Ab呈免疫反应。不同地理区域的α-EAS Ab免疫反应率没有差异。
结论
这是第一项使用免疫组织化学方法在泰国不同地区确认幽门螺杆菌感染的研究。泰国东亚型CagA幽门螺杆菌的流行率较低。泰国胃癌发病率低可能归因于癌前病变的低流行率。与其他地区相比，南部地区胃癌发病率低可能与幽门螺杆菌感染、癌前病变和CagA阳性幽门螺杆菌菌株的较低流行率有关。
Zotero 插件