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目的:探讨幽门螺杆菌(Hp)细胞毒素相关蛋白A(CagA)阳性Hp感染与胃癌发病的关系。 方法:采用病例对照研究的方法,选择可能与胃癌发生有关的危险因素制定统一的调查表,胃癌组与对照组进行配比,配比比例为1:2。患者末梢血中HP-CagA抗体的检测采用斑点金免疫渗滤法。胃癌的危险因素分析采用单因素及多因素Logistic回归分析、双因素分层分析。 结果:(1)不同年龄段的胃癌患者CagA阳性Hp感染率差异较大,年龄越小感染率越高,小于50岁胃癌患者100％感染CagA阳性Hp,随着年龄增长,感染率下降,呈显著的负相关(P<0.01)。(2)CagA阳性Hp感染率在高、中、低分化腺癌中分别为8。5％,28.5％,63.0％,彼此间相比,差异有显著性(P<0.05),CagA阳性Hp感染与低分化腺癌关系最密切。(3)胃癌组与对照1组及对照2组的1:1配比的单因素Logistic回归分析中,食酸辣食物、吸烟、进食不规律、精神因素、身体状况较差、饮酒、Ⅰ级亲属共患病及CagA阳性Hp感染等因素与胃癌的发生呈正相关,其中以CagA阳性Hp感染的OR最大,关系最为密切。进食新鲜蔬菜、水果与胃癌发病呈负相关,为胃癌的保护性因素。(4)多因素Logistic回归分析中,CagA阳性Hp感染、吸烟、饮酒、进食不规律、精神因素等因素与胃癌的发生呈明显的正相关,其中以CagA阳性Hp感染的OR最大
Objective: To investigate the relationship between Helicobacter pylori (Hp) cytotoxin-associated protein A (CagA) -positive Hp infection and the pathogenesis of gastric cancer. Methods: A case-control study was conducted to select a common questionnaire that might be related to the risk factors of gastric cancer. The ratio of gastric cancer to control was 1: 2. Detection of HP-CagA antibodies in peripheral blood of patients was performed by dot immunogold filtration. Risk factors for gastric cancer using univariate and multivariate Logistic regression analysis, two-factor stratified analysis. Results: (1) The prevalence of CagA-positive Hp in different age groups was significantly different. The younger the age, the higher the infection rate. The less positive in 50-year-old gastric cancer was CagA-positive Hp. The infection rate decreased with age Significant negative correlation (P <0.01). (2) The prevalence of CagA-positive Hp infection was 8.5%, 28.5% and 63.0% in high, moderate and poorly differentiated adenocarcinomas respectively, with significant difference (P <0.05) and CagA positive Hp infection The most closely related with poorly differentiated adenocarcinoma. (3) Logistic regression analysis of 1: 1 ratio in gastric cancer group, control group 1 and control group 2 showed no significant difference between the two groups in terms of smoking and eating, irregular smoking, mental factors, poor physical condition, alcohol consumption, Family co-morbidity and CagA-positive Hp infection and other factors and the occurrence of gastric cancer was positively correlated, of which CagA-positive Hp infection OR largest, most closely. Eating fresh vegetables, fruits and gastric cancer was negatively correlated, a protective factor for gastric cancer. (4) In the multivariate Logistic regression analysis, CagA-positive Hp infection, smoking, drinking, eating irregularity, mental factors and other factors were positively correlated with the occurrence of gastric cancer, of which CagA-positive Hp infection OR was the largest