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目的通过检测不同部位和不同组织类型中胃癌组织中幽门螺杆菌(H.pylori)和细胞毒素相关基因(CagA基因),探讨H.pylori、CagA基因与胃癌的关系,以及H.pylori、CagA基因导致胃癌的可能机制。方法应用快速尿素酶试验和组织切片革兰染色及血清H.pylori CagA抗体检测胃癌患者H.pylori,应用PCR检测胃癌组织中H.pylori CagA基因。结果胃癌组织中随活检部位不同,H.pylori检出率也不同,以胃窦部检出率最高为76.9%,与胃体大弯侧、胃角和贲门相比差异均有非常显著性(P<0.005),胃体大弯侧、胃角与贲门相比差异均有非常显著性(P<0.005),胃底与贲门相比差异无显著性(P>0.05)。胃窦部癌的CagA检出率(85.6%)最高,与其他部位相比差异均有非常显著性(P<0.005),胃角胃癌CagA检出率显著高于胃体大弯侧和贲门胃癌(P<0.005)。高分化胃癌H.pylori检出率为73.1%,低分化胃癌H.pylori检出率为44.1%,二者相比差异均有非常显著性(P<0.01)。肠型胃癌H.pylori检出率为76.7%,弥漫型胃癌H.pylori检出率为33.3%,二者相比差异有显著性(P<0.05),高分化胃癌CagA检出率为26.3%,低分化胃癌CagA检出率为80.0%,二者相比差异均有非常显著性(P<0.01)。肠型胃癌CagA检出率为80.4%,弥漫型胃癌CagA检出率为57.1%,二者相比差异无显著性(P>0.05)。结论不同部位和不同组织类型中胃癌组织中H.pylori和CagA基因的表达存在一定差异性,对探讨胃癌的发生及胃癌的防治有一定的指导意义。
Objective To investigate the relationship between H.pylori and CagA genes and gastric cancer by detecting H.pylori and cytotoxin related genes (CagA) in gastric cancer tissues at different sites and in different tissue types, and to investigate the relationship between H.pylori and CagA genes Possible mechanism leading to gastric cancer. Methods Rapid urease test and histological sections of Gram stain and serum H. pylori CagA antibody detection H.pylori gastric cancer patients, the application of PCR detection of gastric cancer H.pylori CagA gene. Results The detection rate of H.pylori varied with the location of biopsy in gastric cancer tissues. The detection rate of gastric H.pylori was the highest (76.9%), which was significantly different from that of gastric lesion, gastric angle and cardia (P <0.005). There was significant difference between gastric curvature at the greater curvature side and gastric gland (P <0.005). There was no significant difference between gastric fundus and cardia (P> 0.05). The detection rate of CagA in gastric cancer was the highest (85.6%), which was significantly different from other sites (P <0.005). The detection rate of CagA in gastric cancer was significantly higher than that in gastric curvature (P <0.005). The detection rate of H.pylori in well-differentiated gastric cancer was 73.1%, and the detection rate of H.pylori in poorly differentiated gastric cancer was 44.1%. There was a significant difference between the two (P <0.01). The detection rate of H.pylori was 76.7% in intestinal type gastric cancer and 33.3% in diffuse gastric carcinoma, the difference was significant (P <0.05), the positive rate of CagA in well-differentiated gastric cancer was 26.3% . The detection rate of CagA in poorly differentiated gastric cancer was 80.0%, which was significantly different between the two groups (P <0.01). The positive rate of CagA was 80.4% in intestinal type gastric cancer and 57.1% in diffuse type gastric cancer. There was no significant difference between the two groups (P> 0.05). Conclusion There are some differences in the expression of H.pylori and CagA genes between different tissues and different types of gastric cancer tissues, which may be helpful for the study of the occurrence of gastric cancer and the prevention and treatment of gastric cancer.