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目的研究食管鳞癌发生与幽门螺杆菌(Hp)感染两者之间的关系。方法选择2014年至2015年住院的72例食管鳞癌患者作为病例组,另选同时期75例慢性食管炎患者(慢性食管炎组)、60例重度食管不典型增生患者(重度食管不典型增生组)、38例轻-中度食管不典型增生患者(轻中度食管不典型增生组)作为三个对照组。整理四组患者相关的临床资料,利用Warthin-Starry银染及快速尿素酶法对其Hp感染情况进行检测,同时比较四组患者Hp阳性感染率,Hp感染与食管鳞癌患者临床病理特点的关系。统计学检验水准取α=0.05,采用分割χ~2检验时,α’校正为0.017。结果各组患者的Hp感染率依慢性食管炎组→轻-中度不典型增生组→重度不典型增生组→食管癌组之序呈上升趋势,差异具有统计学意义(P<0.01),且食管癌组患者的Hp感染率均高于其他三组(P均<0.017)。Hp感染与食管癌患者性别(P=0.924)、年龄(P=0.933)、肿瘤大小(P=0.985)、部位(P=0.926)及淋巴结的转移与否(P=1.000)之间无统计学关联,与肿瘤的分化程度有关(P=0.046)。结论在食管癌的发生发展的过程,Hp感染起着重要的影响作用。
Objective To study the relationship between the occurrence of esophageal squamous cell carcinoma and Helicobacter pylori (Hp) infection. Methods Seventy-two patients with esophageal squamous cell carcinoma who were admitted to hospital from 2014 to 2015 were enrolled in this study. 75 patients with chronic esophagitis (chronic esophagitis) and 60 patients with severe esophageal dysplasia (severe esophageal atypical hyperplasia Group), and 38 patients with mild to moderate esophageal atypical hyperplasia (mild to moderate esophageal atypical hyperplasia group) served as the three control groups. The clinical data of four groups of patients were collected. The Hp infection status was detected by Warthin-Starry silver staining and rapid urease assay. The relationship between Hp positive infection rate, Hp infection and clinicopathological features of esophageal squamous cell carcinoma was also compared . Statistical test to take α = 0.05, using the split χ ~ 2 test, α ’corrected to 0.017. Results The Hp infection rate in each group showed an upward trend according to the sequence of chronic esophagitis → mild-moderate atypical hyperplasia → severe dysplasia → esophageal cancer, the difference was statistically significant (P <0.01), and Hp infection rate in esophageal cancer patients were higher than the other three groups (all P <0.017). There was no statistical significance between Hp infection and esophageal cancer (P = 0.924), age (P = 0.933), tumor size (P = 0.985), location (P = 0.926) and lymph node metastasis Associated with the degree of tumor differentiation (P = 0.046). Conclusion Hp infection plays an important role in the development of esophageal cancer.