Association between Helicobacter Pylori Colonization and Iron Death Gene Expression and Clinicopathology and Prognosis of Gastric Cancer
Objective To investigate the relationship between helicobacter pylori colonization,iron death gene expression and clinicopathological features and prognosis of gastric cancer.Methods 159 gastric cancer patients who underwent radical surgery for D2 gastric cancer at the Cancer Prevention and Control Center of the First Affiliated Hospital of Air Force Military Medical University from January 2018 to September 2019 were selected.Data on patients'age,gender,preoperative routine laboratory measurements,postoperative tumor characteristics and survival were collected.Immunohistochemistry was used to analyze the expression of solute carrier family 1 member 5(SLC1A5)in paracancerous normal tissues and gastric cancer tissues,and enzyme-linked immunosorbent assay was used to assess the preoperative serum level of helicobacter pylori immunoglobulin G(IgG)antibody.Results The difference between patients with and without H.pylori infection was statistically significant in terms of T stage,number of lymph node metastases≥3 and SLC1A5 expression level(P＜0.05).SLC1A5 immunohistochemical scores were significantly increased in gastric cancer tissues compared with normal tissues adjacent to the cancer(6.35±3.40 vs 3.08±1.75,t=10.75,P＜0.001).The difference between patients with low and high expression of SLC1A5 was statistically significant n tumor grade,nerve invasion,T stage and H.pylori infection(P＜0.05).Cox analysis showed that H.pylori infection(HR=3.786,95%CI=2.284-6.274),tumor grade(HR=1.877,95%CI=1.254-2.810),SLC1A5 expression(HR=1.112,95%CI=1.035-1.193)were independent influencing factors of poor prognosis in patients with gastric cancer(P＜0.05).The HSG score was constructed by combining H.pylori infection,tumor grade,and SLC1A5 expression,and the incidence of HSG 0,HSG 1,HSG 2,and HSG 3 fatal events was 6.25%(1/16),34.29%(12/35),64.91%(37/57),and 88.23%(45/51),respectively.The difference in overall survival probability comparison among different HSG scores was statistically significant(Log-rank=31.06,P＜0.001).Conclusion Helicobacter pylori infection,tumor grade and SLC1A5 expression are independent influencing factors of poor prognosis in patients with gastric cancer.The HSG score based on the combination of the three factors can effectively stratify the outcomes of patients after radical resection,and help to improve clinical decision-making and ensure appropriate treatment.
helicobacter pylorigastric cancersolute carrier family 1 member 5clinicopathologyprognosis
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