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目的探讨新疆维吾尔族人群幽门螺旋杆菌(H.pylori,Hp)毒力CagA和VacA表达与胃癌的相关性。方法采用病例-对照研究方法选取2014年1月至2016年11月新疆维吾尔自治区人民医院病理学确诊的新疆维吾尔族人群胃癌患者98例为病例组,同期确诊为非肿瘤性胃病的维吾尔族患者298例为对照组。采用免疫印迹法检测两组患者血清Hp抗体水平及其毒力CagA和VacA表达情况。同时比较两组患者的年龄、性别、体质量指数(BMI)、吸烟史、饮酒史、肿瘤家史等。将有统计学意义的因素及Hp CagA和VacA表达进一步带入Logistic回归方程,筛选维吾尔族人群胃癌的高危因素,并探讨Hp毒力CagA和VacA表达与胃癌相关性。结果病例组患者Hp血清学阳性率为76.5%,对照组阳性率为72.1%,两组比较差异无统计学意义(P>0.05);对照组患者中十二指肠溃疡组、胃溃疡组和浅表性胃炎组的Hp血清学阳性率分别为82.7%,85.1%和58.3%,浅表性胃炎组明显低于胃溃疡组和十二指肠溃疡组,差异均有统计学意义(P<0.05);病例组患者的CagA+、VacA+及CagA+与VacA+全阳性率分别为81.3%、84.0%和81.3%,明显高于对照组的62.8%、61.9%和61.9%,且差异均有统计学意义(P<0.05);单因素分析显示,病例组与对照组在吸烟史、饮酒史、肿瘤家族史、常食用腌制食物和CagA+VacA+全阳性表达方面比较差异均有统计学意义(P<0.05);Logistic回归分析显示,肿瘤家族史(OR=3.21,95%CI:1.69~5.22,P<0.05)和CagA+VacA+全阳性表达(OR=2.12,95%CI:1.23~4.21,P<0.05)为胃癌的独立危险因素。结论新疆维吾尔族胃癌患者Hp感染率较高,CagA+VacA+全阳性表达可能是胃癌的独立危险因素。
Objective To investigate the correlation between the expression of CagA and VacA in Helicobacter pylori (H.pylori) and gastric cancer in Xinjiang Uygur population. Methods A case-control study was conducted in 98 Uygur patients with pathologically diagnosed gastric cancer in the People’s Hospital of Xinjiang Uyghur Autonomous Region from January 2014 to November 2016. A total of 98 cases of Uygur patients with Uygur gastric cancer were enrolled in the study. Example for the control group. The level of serum Hp antibody and the expression of CagA and VacA in the two groups were detected by Western blotting. At the same time, the age, gender, body mass index (BMI), smoking history, drinking history, cancer family history and so on were compared between the two groups. Statistically significant factors and Hp CagA and VacA expression were further introduced into Logistic regression equation to screen the risk factors of gastric cancer in Uighur population and to investigate the correlation between Hp virulence CagA and VacA expression and gastric cancer. Results The positive rate of Hp seropositivity was 76.5% in case group and 72.1% in control group, there was no significant difference between the two groups (P> 0.05). In control group, duodenal ulcer group, gastric ulcer group and gastric ulcer group The positive rates of Hp seropositivity in superficial gastritis group were 82.7%, 85.1% and 58.3%, respectively, which were significantly lower in superficial gastritis group than those in gastric ulcer group and duodenal ulcer group (P < 0.05). The positive rates of CagA +, VacA +, CagA + and VacA + in case group were 81.3%, 84.0% and 81.3%, respectively, which were significantly higher than 62.8%, 61.9% and 61.9% in control group, and the differences were statistically significant (P <0.05). Univariate analysis showed that there were significant differences between the case group and the control group in smoking history, alcohol consumption history, family history of cancer, salted foods and CagA + VacA + positive expression (P < 0.05). Logistic regression analysis showed that the family history of cancer (OR = 3.21, 95% CI: 1.69-5.22, P <0.05) and CagA + VacA + 0.05) as an independent risk factor for gastric cancer. Conclusion The prevalence of Hp infection is higher in Uygur patients with gastric cancer. The positive expression of CagA + VacA + may be an independent risk factor for gastric cancer.