摘要
目的 分析幽门螺杆菌(Hp)感染及胃黏膜三叶草因子1/胃动蛋白2(TFF1/GKN2)表达与慢性胃炎可操作的与胃癌风险联系的胃炎评估/可操作的与胃癌风险联系的肠化生评估(OLGA/OLGIM)分期的关系.方法 收集2020年1月-2021年9月海南西部中心医院收治的156例慢性胃炎患者的临床资料,根据OLGA/OLGIM分期及病变严重程度,将患者分为高分期组(Ⅲ~Ⅳ期组,74例)与低分期组(0~Ⅱ期组,82例),比较两组Hp感染及胃黏膜TFF1、GKN2表达情况,分析高分期组Hp感染与TFF1、GKN2表达的一致性,并记录两组Hp细胞毒素相关基因A(CagA)及TFF1、GKN2表达量,分析OLGA/OLGIM分期与Hp CagA、TFF1、GKN2表达量的相关性;对随访时间≥12个月的Hp感染阳性者作进一步分析,比较其随访期间Hp感染及TFF1、GKN2表达、OLGA/OLGIM分期变化.结果 高分期组Hp感染阳性率高于低分期组(P<0.05),胃黏膜TFF1及GKN2表达阳性率均低于低分期组(P<0.05);高分期组患者Hp感染阳性与胃黏膜TFF1、GKN2表达阴性具有较高一致性,Kappa系数分别为0.774、0.570;高分期组胃黏膜Hp CagA mRNA相对表达量高于低分期组(P<0.05),TFF1及GKN2 mRNA相对表达量均低于低分期组(P<0.05);Spearman秩相关分析显示,OLGA分期及OLGIM分期均与胃黏膜Hp CagA mRNA相对表达量呈正相关(r=0.439、0.425),与TFF1及GKN2 mRNA相对表达量呈负相关(r=-0.712、-0.694、-0.705、-0.687);111例Hp感染阳性者有32例获得12个月的随访,随访12个月时,患者Hp感染阳性率及OLGA分期、OLGIM分期降低(P<0.05),TFF1及GKN2表达阳性率升高(P<0.05).结论 Hp感染可增加慢性胃炎病情进展,该作用机制可能与下调胃黏膜TFF1、GKN2的表达有关,可为慢性胃炎的治疗提供新靶点.
OBJECTIVE To analyze the relationship between Helicobacter pylori(Hp)infection,expressions of gastric mucosal Trefoil factor family 1/gastrokine 2(TFF1/GKN2)and Operative Link on Gastritis Assessment/Operative Link on Gastritis and Intestinal-Metaplasia Assessment(OLGA/OLGIM)staging in chronic gastritis.METHODS The clinical data of 156 patients with chronic gastritis admitted to Hainan West Central Hospital between Jan.2020 and Sep.2021were collected,and the patients were divided into high stage group(stage Ⅲ~Ⅳgroup,74 cases)and a low stage group(stage 0~Ⅱ group,82 cases)according to the severity of the lesions and OLGA/OLGIM staging.The Hp infection and expressions of TFF1 and GKN2 in gastric mucosa were compared between the two groups,the consistency of Hp infection with expressions of TFFl and GKN2 in high stage group was analyzed,the expression of Hp cytotoxin-related gene A(CagA)and TFFl and GKN2 in the two groups were recorded,and the correlation between OLGA/OLGIM staging and expressions of Hp CagA,TFF1 and GKN2 was analyzed.Further analysis was performed on those positive for Hp infection at≥12 months follow-up were further analyzed to compare their Hp infection and changes in TFF1 and GKN2 expressions and OLGA/OLGIM staging during the follow-up period.RESULTS The positive rate of Hp infection in high stage group was higher than that in low stage group(P<0.05),while the positive rates of TFF1 and GKN2 expressions in gastric mucosa were lower than those in low stage group(P<0.05).The positive Hp infection in high stage group had higher consistency with the negative expressions of TFFl and GKN2 in gastric mucosa,and the Kappa coefficients were 0.774 and o.570,respectively.The relative expression of Hp CagA mRNA in gastric mucosa in high stage group was higher than that in low stage group(P<0.05),while the relative expressions of TFF1 and GKN2 mRNA were lower than those in low stage group(P<0.05).Spearman rank correlation analysis showed that both the OLGA staging and OLGIM staging were positively correlated with the relative expression of Hp CagA mRNA in gastric mucosa(r=0.439,0.425),and negatively correlated with the relative expressions of TFF1 and GKN2 mRNA(r=-0.712,-0.694,-0.705,and-0.687,respectively).Among111 cases of positive Hp infection,32 cases were followed up for 12 months.At 12 months of follow-up,the positive rate of Hp infection,OLGA staging and OLGIM staging were decreased(P<0.05),and the positive rates of TFF1 and GKN2 expression were increased(P<0.05).CONCLUSION Hp infection could increase the progression of chronic gastritis,and its mechanism might be related to the down-regulations of TFF1 and GKN2 expressions in gastric mucosa,which might provide a new target for the treatment of chronic gastritis.
作者
郭殿华
程芃
陈卿奇
许小康
庞莉
GUO Dian-hua;CHENG Peng;CHEN Qing-qi;XU Xiao-kang;PANG Li(Hainan West Central Hospital(Hainan Branch of the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine),Danzhou,Hainan 571799,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第4期527-531,共5页
Chinese Journal of Nosocomiology
基金
海南省自然科学基金资助项目(821RC733)
海南省卫生健康行业科研基金资助项目(20A200397)。
