Nolen Leisha Diane, Bruden Dana, Miernyk Karen, McMahon Brian J, Sacco Frank, Varner Wayne, Mezzetti Tom, Hurlburt Debby, Tiesinga James, Bruce Michael G
a Arctic Investigations Program , DPEI/NCEZID, Centers for Disease Control and Prevention , Anchorage , AK , USA.
b Liver Disease and Hepatitis Program , Alaska Native Tribal Health Consortium , Anchorage , AK , USA.
Int J Circumpolar Health. 2018 Dec;77(1):1510715. doi: 10.1080/22423982.2018.1510715.
Helicobacter pylori infection is common among Alaska native (AN) people, however scant gastric histopathologic data is available for this population. This study aimed to characterise gastric histopathology and H. pylori infection among AN people. We enrolled AN adults undergoing upper endoscopy. Gastric biopsy samples were evaluated for pathologic changes, the presence of H. pylori, and the presence of cag pathogenicity island-positive bacteria. Of 432 persons; two persons were diagnosed with gastric adenocarcinoma, two with MALT lymphoma, 40 (10%) with ulcers, and 51 (12%) with intestinal metaplasia. Fifty-five per cent of H. pylori-positive persons had cag pathogenicity island positive bacteria. The gastric antrum had the highest prevalence of acute and chronic moderate-severe gastritis. H. pylori-positive persons were 16 and four times more likely to have moderate-severe acute gastritis and chronic gastritis (p < 0.01), respectively. An intact cag pathogenicity island positive was correlated with moderate-severe acute antral gastritis (53% vs. 31%, p = 0.0003). H. pylori-positive persons were more likely to have moderate-severe acute and chronic gastritis compared to H. pylori-negative persons. Gastritis and intestinal metaplasia were most frequently found in the gastric antrum. Intact cag pathogenicity island positive was correlated with acute antral gastritis and intestinal metaplasia.
幽门螺杆菌感染在阿拉斯加原住民（AN）中很常见，然而该人群的胃组织病理学数据却很少。本研究旨在描述AN人群的胃组织病理学和幽门螺杆菌感染情况。我们纳入了接受上消化道内镜检查的AN成年人。对胃活检样本进行病理变化、幽门螺杆菌存在情况以及空泡毒素致病岛阳性细菌存在情况的评估。在432人中，2人被诊断为胃腺癌，2人被诊断为黏膜相关淋巴组织淋巴瘤，40人（10%）患有溃疡，51人（12%）患有肠化生。55%的幽门螺杆菌阳性者有空泡毒素致病岛阳性细菌。胃窦部急性和慢性中重度胃炎的患病率最高。幽门螺杆菌阳性者患中重度急性胃炎和慢性胃炎的可能性分别是阴性者的16倍和4倍（p<0.01）。完整的空泡毒素致病岛阳性与中重度急性胃窦炎相关（53%对31%，p=0.0003）。与幽门螺杆菌阴性者相比，幽门螺杆菌阳性者更易患中重度急性和慢性胃炎。胃炎和肠化生最常见于胃窦部。完整的空泡毒素致病岛阳性与急性胃窦炎和肠化生相关。
