The relationship between autoimmune gastritis complicated with Helicobacter pylori infection and gastric cancer
扫码查看
点击上方二维码区域，可以放大扫码查看
原文链接
维普
万方数据
目的 探究自身免疫性胃炎(AIG)、幽门螺杆菌(Hp)感染与胃癌之间的关系.方法 选择2012年1月—2019年1月新疆维吾尔自治区人民医院消化内科收治的AIG患者316例作为研究对象,根据是否合并幽门螺杆菌感染分为Hp组(n=91)和非Hp组(n=225);根据Hp感染状态进一步将Hp组患者分为既往感染亚组(n=73)和活动性感染亚组(n=18);比较2组胃癌发生风险、胃癌发生率、胃癌筛查指标及胃癌发病部位差异,并进一步比较2亚组胃癌发生率.结果 与非Hp组比较,Hp组患者在抗壁细胞抗体(PCA)阳性比例和抗内因子抗体(IFA)阳性比例方面差异无统计学意义(x2/P=0.191/0.662,0.277/0.599);Hp组患者胃蛋白酶原(PG)Ⅰ水平及PG Ⅰ/PG Ⅱ降低(t/P=2.133/0.034,2.001/0.046),胃泌素17(G-17)升高(t/P=2.045/0.042).与既往感染亚组比较,活动性感染亚组患者14C呼气试验结果显著升高(t/P=34.990/＜0.001);既往感染亚组患者Hp感染时距入组间隔时间平均为(2.12±0.94)年.与非 Hp 组比较,Hp 组 OLGA 和 OLGIM 分期 Ⅲ～Ⅳ期比例升高(x2/P=8.314/0.004,5.242/0.022),胃癌发生风险较高(12.09％vs.5.33％,x2/P=4.380/0.036);Hp组胃体及贲门癌发生率显著下降,胃窦癌发生率升高(58.33％vs.100％,36.36％vs.0％,P=0.037);与既往感染亚组比较,活动性感染亚组患者胃癌发生率更高(27.78％vs.8.22％,x2/P=5.198/0.023).结论 AIG患者合并Hp感染尤其是活动性感染时的胃癌发生风险显著高于单纯AIG患者.
Objective Investigating the relationship between autoimmune gastritis,Helicobacter pylori infection and gastric cancer through a retrospective cohort study.Methods Patients with autoimmune gastritis in our hospital were enrolled and divided into non-Hp group(n=225)and an Hp group(n=91)according to the status of Helicobacter pylori infection.The baseline characteristics,OLGA and OLGIM stages,screening indicators of gastric cancer,incidence and loca-tion of gastric cancer were statistically analyzed between the two groups.The incidence of gastric cancer was further com-pared between the two subgroups.Results Compared with non-Hp group,there were no statistically significant differences in PCA and IFA positive proportion in Hp group(x2/P=0.191/0.662,0.277/0.599);The level of PG Ⅰ and PG Ⅰ/PGⅡ in Hp group decreased(t/P=2.133/0.034,2.001/0.046),and G-17 increased(t/P=2.045/0.042);Compared with past infection sub-groups,active infection subgroup of patients with a significant rise in 14C breath test results(t/P=34.99/＜0.05);The aver-age time from infection to enrolled group in past infection subgroups was(2.12±0.94)years;Compared with the non-Hp group,the performance of OLGA and OLGIM staging in Hp group were worse(41.76％vs.25.33％,19.78％vs.1022％,x2/P=8.314/0.004,5242/0.022),and the gastric cancer risk is higher(112.09％vs.5.33％,x2/P=4.380/0.036);The incidence of gastric body and cardia cancer in Hp group was significantly lower,and the incidence of gastric antrum cancer was signifi-cantly higher(5833％vs.100％,36.36％vs.0％,P=0.037).Compared with the previous infection subgroup,the incidence of gastric cancer in the active infection subgroup was higher(27.78％vs.822％,x2/P=5.198/0.023).Conclusion The risk of gastric cancer in AIG patients with Hp infection,especially active Hp infection,is significantly higher than that in AIG pa-tients without HP infection.
维普
万方数据
