Beales I L, Crabtree J E, Scunes D, Covacci A, Calam J
Department of Medicine, Royal Postgraduate Medical School, London, UK.
Eur J Gastroenterol Hepatol. 1996 Jul;8(7):645-9.
Strains of Helicobacter pylori which express the product of the cytotoxin associated gene A(CagA) are associated with duodenal ulceration. Also there is evidence that the presence of serum IgG antibodies to CagA is associated with an increased risk of gastric cancer of the intestinal type. Gastric atrophy is a precursor of intestinal-type gastric cancer so we have investigated whether antibodies to CagA are associated with gastric atrophy. In H. pylori infected patients, IgG antibodies to CagA were present in 24/38 (63%) of non-ulcer patients with atrophy compared with 13/40 (33%) of patient-controls with neither atrophy nor ulcer (P < 0.02). CagA antibodies were also more prevalent in patients with duodenal ulcers; 15/20 (75%) or gastric ulcers 5/5 (100%) than in the patient-controls (P < 0.005 and < 0.02 respectively). These results show that circulating IgG antibodies to CagA are associated with gastric atrophy, as well as peptic ulcer disease. Atrophy is a precursor of gastric cancer so support the hypothesis that certain strains of H. pylori are more likely to cause gastric cancer.
表达细胞毒素相关基因A（CagA）产物的幽门螺杆菌菌株与十二指肠溃疡有关。也有证据表明，血清中抗CagA IgG抗体的存在与肠型胃癌风险增加有关。胃萎缩是肠型胃癌的前驱病变，因此我们研究了抗CagA抗体是否与胃萎缩有关。在幽门螺杆菌感染患者中，24/38（63%）无溃疡的萎缩患者存在抗CagA IgG抗体，而既无萎缩也无溃疡的对照患者中这一比例为13/40（33%）（P<0.02）。十二指肠溃疡患者中CagA抗体也更常见；十二指肠溃疡患者为15/20（75%），胃溃疡患者为5/5（100%），均高于对照患者（分别为P<0.005和<0.02）。这些结果表明，循环中的抗CagA IgG抗体与胃萎缩以及消化性溃疡病有关。萎缩是胃癌的前驱病变，因此支持某些幽门螺杆菌菌株更易引发胃癌这一假说。
