胃癌家族史与慢性胃炎幽门螺杆菌感染和胃黏膜病理变化的关系
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摘要
背景:胃癌家族史是胃癌遗传易感性的重要标志,研究显示胃癌家族史对慢性胃炎患者的幽门螺杆菌(Hp)感染和临床病理表现可能有一定影响。目的:探讨慢性胃炎患者胃癌家族史与Hp感染和胃黏膜病理变化的关系。方法:选取312例慢性胃炎患者,评估胃癌家族史与Hp感染、胃黏膜炎症程度、炎症活动性、萎缩和肠化生程度的关系。结果:312例慢性胃炎患者中有胃癌家族史者165例(52.9%),无胃癌家族史者147例(47.1%),有胃癌家族史者Hp感染率、胃黏膜萎缩、肠化生程度均显著高于无胃癌家族史者(P<0.05),但两组间胃黏膜炎症程度、炎症活动性差异无统计学意义(P>0.05)。结论:有胃癌家族史的慢性胃炎患者Hp感染率较高,并可加重胃黏膜萎缩和肠化生。
Background: Family history of gastric cancer is an important indicator of genetic susceptibility. Studies have shown that the family history of gastric cancer might have impact on Helicobacter pylori( Hp) infection and clinicopathological manifestations in patients with chronic gastritis. Aims: To investigate the correlation of family history of gastric cancer with Hp infection and pathological changes of gastric mucosa in patients with chronic gastritis. Methods: A total of 312 patients with chronic gastritis were enrolled to study the relationship between family history of gastric cancer and Hp infection,degree of gastric mucosal inflammation,activity of inflammation,and degree of atrophy and intestinal metaplasia. Results:In the 312 patients with chronic gastritis,165( 52. 9%) had family history of gastric cancer,and 147( 47. 1%) without family history of gastric cancer. Incidence of Hp infection,degree of gastric mucosal atrophy and intestinal metaplasia in patients with family history of gastric cancer were significantly higher than those without( P < 0. 05),but no significant differences in degree and activity of inflammation were found between the two groups( P > 0. 05). Conclusions: The incidence of Hp infection is higher in chronic gastritis patients with family history of gastric cancer. Family history of gastric cancer may aggravate gastric mucosal atrophy and intestinal metaplasia.
Background: Family history of gastric cancer is an important indicator of genetic susceptibility. Studies have shown that the family history of gastric cancer might have impact on Helicobacter pylori( Hp) infection and clinicopathological manifestations in patients with chronic gastritis. Aims: To investigate the correlation of family history of gastric cancer with Hp infection and pathological changes of gastric mucosa in patients with chronic gastritis. Methods: A total of 312 patients with chronic gastritis were enrolled to study the relationship between family history of gastric cancer and Hp infection,degree of gastric mucosal inflammation,activity of inflammation,and degree of atrophy and intestinal metaplasia. Results:In the 312 patients with chronic gastritis,165( 52. 9%) had family history of gastric cancer,and 147( 47. 1%) without family history of gastric cancer. Incidence of Hp infection,degree of gastric mucosal atrophy and intestinal metaplasia in patients with family history of gastric cancer were significantly higher than those without( P < 0. 05),but no significant differences in degree and activity of inflammation were found between the two groups( P > 0. 05). Conclusions: The incidence of Hp infection is higher in chronic gastritis patients with family history of gastric cancer. Family history of gastric cancer may aggravate gastric mucosal atrophy and intestinal metaplasia.
引文
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3 中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组;刘文忠,谢勇,成虹,等.第四次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2012,17(10):618-625.
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5 王仲略,周刚,沈慧琳,等.慢性萎缩性胃炎患者的危险因素与临床治疗效果[J].中华医院感染学杂志,2015,25(8):1817-1819.
6 Rokkas T,Sechopoulos P,Pistiolas D,et al.Helicobacter pylori infection and gastric histology in first-degree relatives of gastric cancer patients:a meta-analysis[J].Eur J Gastroenterol Hepatol,2010,22(9):1128-1133.
7 Nishizawa T,Suzuki H,Sakitani K,et al.Family history is an independent risk factor for the progression of gastric atrophy among patients with Helicobacter pylori infection[J].United European Gastroenterol J,2017,5(1):32-36.
8 Marcos-Pinto R,Carneiro F,Dinis-Ribeiro M,et al.Firstdegree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia[J].Aliment Pharmacol Ther,2012,35(12):1451-1459.
9 Zullo A,Hassan C,Romiti A,et al.Follow-up of intestinal metaplasia in the stomach:When,how and why[J].World J Gastrointest Oncol,2012,4(3):30-36.
10 Oh S,Kim N,Yoon H,et al.Risk factors of atrophic gastritis and intestinal metaplasia in first-degree relatives of gastric cancer patients compared with age-sex matched controls[J].J Cancer Prev,2013,18(2):149-160.
11 黄曼玲,孙圣斌,徐丹,等.幽门螺杆菌感染与胃镜下的不同胃炎及病理之间的关系[J].实用医学杂志,2014,30(14):2245-2247.
12 Kodama M,Murakami K,Okimoto T,et al.Ten-year prospective follow-up of histological changes at five points on the gastric mucosa as recommended by the updated Sydney system after Helicobacter pylori eradication[J].J Gastroenterol,2012,47(4):394-403.
2 中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2013,18(1):24-36.
3 中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组;刘文忠,谢勇,成虹,等.第四次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2012,17(10):618-625.
4 刘慧,唐启明,周泽伟,等.渝西地区幽门螺杆菌感染现状及家庭聚集性研究[J].检验医学与临床,2017,14(1):117-118.
5 王仲略,周刚,沈慧琳,等.慢性萎缩性胃炎患者的危险因素与临床治疗效果[J].中华医院感染学杂志,2015,25(8):1817-1819.
6 Rokkas T,Sechopoulos P,Pistiolas D,et al.Helicobacter pylori infection and gastric histology in first-degree relatives of gastric cancer patients:a meta-analysis[J].Eur J Gastroenterol Hepatol,2010,22(9):1128-1133.
7 Nishizawa T,Suzuki H,Sakitani K,et al.Family history is an independent risk factor for the progression of gastric atrophy among patients with Helicobacter pylori infection[J].United European Gastroenterol J,2017,5(1):32-36.
8 Marcos-Pinto R,Carneiro F,Dinis-Ribeiro M,et al.Firstdegree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia[J].Aliment Pharmacol Ther,2012,35(12):1451-1459.
9 Zullo A,Hassan C,Romiti A,et al.Follow-up of intestinal metaplasia in the stomach:When,how and why[J].World J Gastrointest Oncol,2012,4(3):30-36.
10 Oh S,Kim N,Yoon H,et al.Risk factors of atrophic gastritis and intestinal metaplasia in first-degree relatives of gastric cancer patients compared with age-sex matched controls[J].J Cancer Prev,2013,18(2):149-160.
11 黄曼玲,孙圣斌,徐丹,等.幽门螺杆菌感染与胃镜下的不同胃炎及病理之间的关系[J].实用医学杂志,2014,30(14):2245-2247.
12 Kodama M,Murakami K,Okimoto T,et al.Ten-year prospective follow-up of histological changes at five points on the gastric mucosa as recommended by the updated Sydney system after Helicobacter pylori eradication[J].J Gastroenterol,2012,47(4):394-403.