不同毒力幽门螺杆菌感染与结直肠息肉的相关性分析
Correlation analysis between Helicobacter pylori infection with different virulence and colorectal polyps
邹荣 1方向明1
作者信息
- 1. 武汉科技大学附属普仁医院消化内科,湖北武汉 430081
- 折叠
摘要
[目的]探讨不同毒力幽门螺杆菌(Helicobacter pylori,Hp)感染与结直肠息肉发生的相关性.[方法]按入选标准和排除条件筛选出400例患者作为研究对象.由13C或14C尿素呼气试验诊断为Hp感染患者行Hp血清抗体检测,并将抗体阳性者分为Hp Ⅰ型抗体组(Ⅰ型组)和Hp Ⅱ型抗体组(Ⅱ型组),比较不同毒力Hp感染与结直肠息肉相关性.最后根据Hp表达细胞毒素相关基因A(Cytotoxin Associated Gene A,CagA)和空泡变性细胞毒素A(Vacuolation Toxin A,Vac A)的差异,将Hp血清抗体阳性者分为CagA+VacA组、仅含CagA组和仅含VacA组,比较各组间结直肠息肉的临床特征差异.[结果]Ⅰ型组息肉检出率高于Ⅱ型组(94.5％比44.1％,P＜0.05),Ⅰ型组息肉在左半结肠的检出率高于Ⅱ型组(51.8％比11.9％,P＜0.05),结直肠多发性息肉在Ⅰ型组中的检出率显著高于Ⅱ型组(73.6％比25.4％,P＜0.05),腺瘤性息肉在Ⅰ型组中的检出率明显高于Ⅱ型组(73.6％比22.0％,P＜0.05).Ⅰ型组与Ⅱ型组间息肉直径大小差异无统计学意义(P=0.219).左半结肠息肉在仅含VacA组中的检出率明显高于CagA+VacA组(59.1％比53.2％,P＜0.05)及仅含CagA组(59.1％比42.3％,P＜0.05),CagA+VacA组中腺瘤性息肉检出率高于仅含CagA组(80.6％比73.1％,P＜0.05)和仅含VacA组(80.6％比54.5％,P＜0.05).CagA+VacA组、仅含CagA组和仅含VacA组间息肉数量比较差异无统计学意义(P=0.631).[结论]不同毒力的Hp感染与结直肠息肉的生长部位、数量和病理类型有关,而与息肉的直径大小无关.感染同时表达CagA和VacA两种抗体的Hp时,结直肠息肉病理类型以腺瘤性息肉为主.
Abstract
[Objective]To investigate the relationship between different virulence Helicobacter pylori(Hp)infection and colorectal polyps.[Methods]According to the inclusion criteria and exclusion condi-tions,400 patients were selected as study objects.Patients with Hp infection diagnosed by 13 C or 14 C urea breath test were tested for Hp serum antibody,and those with positive antibody were divided into Hp typeⅠ antibody group and Hp type Ⅱ antibody group,and compared the different virulence Hp infection associ-ated with colorectal polyps.Finally,according to the difference in Hp expression of cytotoxin associated gene A and vacuolation Toxin A,Hp seropositive individuals were divided into three groups:those express-ing CagA and VacA,those expressing only CagA,and those expressing only VacA,to compare the differencesin polyp characteristics among the groups.[Results]The detection rate of polyps in the HpⅠ an-tibody-positive group was higher than that in the Hp Ⅱ antibody-positive group(94.5％vs 44.1％,P＜0.05).The detection rate of polyps in the left colon in the Hp Ⅰ antibody group was higher than that in the Hp Ⅱ antibody group(51.8％vs 11.9％,P＜0.05).The detection rate of colorectal multiple polyps in the Hp Ⅰ antibody group was significantly higher than that in the Hp Ⅱ antibody group(73.6％vs 25.4％,P＜0.05).The detection rate of adenomatous polyps in the Hp type Ⅰ antibody group was significantly higher than that in the Hp type Ⅱ antibody group(73.6％vs 22.0％,P＜0.05).There was no significant differ-ence in polyp diameter between the Hp type Ⅰ antibody group and the Hp type Ⅱ antibody group(P=0.219).The detection rate of left colonic polyps in the VacA only expression group was significantly higher than that in the CagA and VacA antibody expression group(59.1％vs 53.2％,P＜0.05)and the CagA only expression group(59.1％vs 42.3％,P＜0.05),the detection rate of adenomatous polyps in the CagA and VacA antibody group was higher than that in the CagA only expression group(80.6％vs 73.1％,P＜0.05)and the VacA only expression group(80.6％vs 54.5％％,P＜0.05).There was no significant difference in the number of polyps among the three groups(P=0.631).[Conclusion]Hp infection with different viru-lence is related to the growth site,number and pathological type of colorectal polyps,but not to the diame-ter of polyps.When infected with Hp expressing both CagA and VacA antibodies,the pathological types of colorectal polyps were mainly adenomatous polyps.
关键词
结直肠息肉/腺瘤性息肉/幽门螺杆菌/幽门螺杆菌抗体分型Key words
colorectal polyps/adenomatous polyps/Helicobacter pylori/Helicobacter pylori antibody type引用本文复制引用
基金项目
武汉市临床医学科研项目面上项目(WX20 C14)
出版年
2024
NETL
NSTL
万方数据