Hp感染与胃炎类型及病理分型关系的探讨
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摘要
目的:分析不同类型胃炎幽门螺杆菌(Hp)感染情况与不同病理分型的关系。方法:收治行胃镜检查的胃炎患者1 314例;采用胃镜下黏膜活检,对活检标本进行病理分析,并对患者胃炎进行分型,采用病理组织学及~(13)C呼气试验对Hp进行检测。结果:慢性萎缩性胃炎患者Hp阳性率84.36%,显著高于慢性非萎缩性胃炎组(45.64%)(P<0.05);重度及中度炎性反应患者Hp阳性率(80.81%、73.94%)均显著高于轻度炎性反应组患者(53.10%)(P<0.05);胃炎活动组患者Hp阳性率(68.82%)显著高于胃炎不活动组(39.27%)(P<0.05);肠上皮化生及上皮内瘤变患者Hp阳性率(93.97%、95.37%)显著高于无明显病理学改变组患者(37.80%)(P<0.05)。结论:Hp感染与慢性胃炎的发生发展关系密切,慢性萎缩性胃炎及伴有上皮内瘤变、肠上皮化生的患者Hp阳性率较高。
Objective:To analyze the correlation between Hp infection and pathology with different types of gastritis.Methods:1 314 patients with gastritis underwent gastroscopy were selected.The gastroscopic biopsy was performed,biopsy specimens were pathologically analyzed,and gastritis was typed.The Hp was detected by ~(13)C urea breath test and rapid urea enzyme test paper method.Results:The positive rate of Hp in patients with chronic atrophic gastritis was 84.36%,significantly higher than that patients with chronic non-atrophic gastritis(45.64%)(P<0.05).The positive rate of Hp in patients with severe and moderate inflammation(80.81%,73.94%)was significantly higher than that in patients with mild inflammation(53.10%)(P<0.05).The positive rate of Hp in patients with active gastritis(68.82%)was significantly higher than that in patients with non-active gastritis(39.27%)(P<0.05).The positive rate of Hp in patients with ntestinal metaplasia and epithelial neoplasia in patients(93.97% and 95.37%)was significantly higher than that in patients without significant pathological changes(37.80%)(P<0.05).Conclusion:Hp infection is closely related to the development of chronic gastritis.Chronic atrophic gastritis and patients with intraepithelial neoplasia and intestinal metaplasia have higher Hp positive rates.
Objective:To analyze the correlation between Hp infection and pathology with different types of gastritis.Methods:1 314 patients with gastritis underwent gastroscopy were selected.The gastroscopic biopsy was performed,biopsy specimens were pathologically analyzed,and gastritis was typed.The Hp was detected by ~(13)C urea breath test and rapid urea enzyme test paper method.Results:The positive rate of Hp in patients with chronic atrophic gastritis was 84.36%,significantly higher than that patients with chronic non-atrophic gastritis(45.64%)(P<0.05).The positive rate of Hp in patients with severe and moderate inflammation(80.81%,73.94%)was significantly higher than that in patients with mild inflammation(53.10%)(P<0.05).The positive rate of Hp in patients with active gastritis(68.82%)was significantly higher than that in patients with non-active gastritis(39.27%)(P<0.05).The positive rate of Hp in patients with ntestinal metaplasia and epithelial neoplasia in patients(93.97% and 95.37%)was significantly higher than that in patients without significant pathological changes(37.80%)(P<0.05).Conclusion:Hp infection is closely related to the development of chronic gastritis.Chronic atrophic gastritis and patients with intraepithelial neoplasia and intestinal metaplasia have higher Hp positive rates.
引文
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[14]闵丛丛,石岩岩,丁士刚.高致病性幽门螺杆菌标志物的研究进展[J].实用医学杂志2015,31(21):3478-3480.
[15]Rokkas,Liatsos,Petridou,et al.Relationship of Helicobacter pylori CagA(+)status to gastric juice vitamin C levels[J].European Journal of Clinical Investigation,2015,29(1):56-62.
[16]李幕然,刘艳迪,唐涛,等.幽门螺杆菌和慢性胃炎胃黏膜病理变化的关系研究[J].天津医药,2015,43(1):54-56.
[2]Hunt RH,Camilleri M,Crowe SE,et al.The stomach in health and disease[J].Gut,201564(10):1650-1668.
[3]Genta RM,Sonnenberg A.Helicobacter-negative gastritis:a distinct entity unrelated to Helicobacter pylori infection[J].Alimentary Pharmacology&Therapeutics,2015,41(2)218-226.
[4]Roman LD,Lukyanchuk R,Sablin OA,et al Prevalence of H.pylori Infection and Atrophic Gastritis in a Population-based Screening with Serum Biomarker Panel(Gastro Panel?)in St.Petersburg[J].Anticancer Research,2016,36(8):4129.
[5]房静远.中国慢性胃炎共识意见(2017年上海)[J].胃肠病学,2017,22(11):670-687.
[6]李增山,李青.2010年版消化系统肿瘤WHO分类解读[J].中华病理学杂志,201140(5):351-354.
[7]Warren JR.Gastric pathology associated with Helicobacterpylori[J].Gastroenterol Clin North Am,2000,29(3):705-751.
[8]Sonnenberg A,Lash RH,Genta RM.A national study of Helicobacter pylori infection in gastric biopsy specimens[J].Gastroenterology2010,139(6):1894-1901.
[9]Takeshi AMD,Shigeji IMD,Fukiko SMD,et al The role of the HLA-DQA1 gene in resistance to atrophic gastritis and gastric adenocarcinoma induced by Helicobacter pylori infection[J].Cancer,2015,82(6):1013-1018.
[10]Endo S,Ohkusa T,Saito Y,et al.Detection of Helicobacter pylori infection in early stage gastric cancer.A comparison between intestinal-and diffuse-type gastric adenocarcinomas[J].Cancer,2015,75(9):2203-2208.
[11]Yanai H,Takada K,Shimizu N,et al.Epstein-Barr virus infection in non-carcinomatous gastric epithelium[J].Journal of Pathology,2015,183(3):293-298.
[12]Cicone F,Papa A,Lauri C,et al.Thyro-gastric autoimmunity in patients with differentiated thyroid cancer:a prospective study[J].Endocrine,2015,49(1):1-7.
[13]Luo G,Guo M,Liu Z,et al.Blood Neutrophil-Lymphocyte Ratio Predicts Survival in Patients with Advanced Pancreatic Cancer Treated with Chemotherapy[J].Annals of Surgical Oncology,2015,22(2):670.
[14]闵丛丛,石岩岩,丁士刚.高致病性幽门螺杆菌标志物的研究进展[J].实用医学杂志2015,31(21):3478-3480.
[15]Rokkas,Liatsos,Petridou,et al.Relationship of Helicobacter pylori CagA(+)status to gastric juice vitamin C levels[J].European Journal of Clinical Investigation,2015,29(1):56-62.
[16]李幕然,刘艳迪,唐涛,等.幽门螺杆菌和慢性胃炎胃黏膜病理变化的关系研究[J].天津医药,2015,43(1):54-56.