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1.
Background Helicobacter pylori (Hp) is a common and potentially curable cause of gastric mucosa lesion. This study investigated the relationship of Hp infection with histological changes in gastric mucosa and gastric cancer in Hp-positive patients compared with Hp-eradication patients followed up for ten years. Methods From an initial group of 1 006 adults, 552 Hp-positive subjects were randomly assigned to a treatment group (T; n=276) or a placebo group (P; n=276). In the randomized, double-blind, placebo-controlled, parallel trial, T group subjects received oral doses of omeprazole, amoxicillin and clarithromycin for 1 week; those in the P group received a placebo. One month after treatment ended, a 13C urea breath test was performed, and Hp was undetectable in 88.89% of the T group. All subjects were followed at 1, 5, 8, and 10 years after treatment, with endoscopy and biopsies for histological examination. Results Gastric mucosa inflammation was significantly milder in the T group than that in the P group one year after Hp eradication and this persisted for 10 years. Glandular atrophy and intestinal metaplasia (IM) had deteriorated in both groups during ten years. However, the increased score of glandular atrophy at both the gastric antrum and corpus, and IM only at the gastric antrum, in the P group was more obvious than that in the T group. During the 10 years, 9 patients were diagnosed with gastric cancer (2 in the T group; 7 in the P group; P=0.176). When mucosal atrophy was absent at the gastric antrum and corpus when entering the study, the incidence of gastric cancer in the P group (n=6) was much higher than that in the T group (n=0, P=0.013). Conclusions Hp eradication may significantly diminish and delay the development of IM and atrophy gastritis. Hp especially in the early stage of Hp infection. and help halt progression of gastric mucosal inflammation eradication is helpful for reducing the risk for gastric cancer,  相似文献   

2.
Previous study has raised H. pylori infection as a suspected biologic risk factor for gastric cancer. A comparative case-control study involving precancerous lesions and gastric cancer was conducted in Yanzhong county, an area with one of the highest rates of gastric cancer in China to study the relationship between the H. pylori infection and gastric cancer. Subjects in the study were all randomly selected participants of a screening program for gastric cancer sponsored by the Cancer Institute of CAMS in cooperation with Yangzhong county Hospital. Totally, 125 normal controls, 108 superficial gastritis, 111 atrophic gastritis and 110 gastric cancer patients were included in our study according to endoscopy and pathology, result. Status of H. pylori infection was evaluated by measuring Ig G antibody in plasma with ELISA assay.Our result showed Odds ratios of H. pylori infection were higher among gastritis and cancer groups, 4.5(95% CI 2. 5-7.9) for superficial gastritis, 6.3 (95% CI 3.4-12) for atrophic gastritis, 3. 3 (95% CI 1.9-5.9) for gastric cancer. It was found in our study that consumption of pickled vegetables and drinking dirty water increased the relative risk of H. pylori infection for both precancerous lesions and gastric cancer and that H. pylori infection had higher risk of atrophic gastritis and gastric cancer for males and also higher risk of atrophic gastritis for olders. Our results strongly support the casual role played by H, pylori infection in the carcinogenic process of gastric mucosa.  相似文献   

3.
Background Almost half of the world’s population suffer from the Helicobacter pylori (H. pylori) infection, but only some individuals develop gastric diseases with clinical symptoms. One reason for the phenomenon may be the different pathogenicity of infected H. pylori strains. The presence of cytotoxin-associated gene A (cagA) and expression of vacuolating cytotoxin activity encoded by vacuolating cytotoxin gene A (vacA) are considered the two major virulent markers of H. pylori. The aim of this study was to detect dominant cagA/vacA genotypes and coinfection frequency of H. pylori in patients with peptic ulceration (PU) or chronic gastritis (CG), and to determine correlations among different cagA/vacA genotypes, coinfection and severity of the diseases. Methods For each of 139 patients in Zhejiang Province who had been diagnosed as PU or CG based on clinical symptoms and gastroscopy, two gastric biopsy specimens (one from antrum and the other from corpus) for H. pylori isolation were taken by two different disinfected biopsy forceps. One hundred and fifty-six H. pylori strains were isolated from both the antrum and corpus biopsy specimens of 78 patients (36 PU and 42 CG). PCRs were performed to detect cagA genes, and signal (s) and middle (m) regions of vacA genes in the H. pylori isolates. The amplified fragments of dominant vacA gene s and m subtypes from representative H. pylori isolates were sequenced after TA cloning. Dominant cagA/vacA genotypes of the H. pylori isolates, coinfection frequency and correlations among the different genotypes, coinfection and severity of the diseases were determined.Results Of the H. pylori strains isolated from the antrum specimens, 96.2% were cagA gene positive, as were 97.4% of the H. pylori strains isolated from the corpus specimens. Only one s region subtype (s1a) and four m region subtypes m1, m2, m1b and m1b-m2 of vacA gene were found. The proportions of vacA gene subtypes s1a/m1, s1a/m2, s1a/m1b and s1a/m1b-m2 in the 83 strains isolated from the antrum specimens were 7.2%, 61.5%, 30.1% and 1.2%, respectively, while those in the other 84 strains isolated from the corpus specimens were 9.5%, 58.3%, 28.6% and 3.6%, respectively. s1a/m2 (58.3% vs 30.1%, χ2=13.47, P<0.01) and then s1a/m1b (28.6% vs 9.5 %, χ2=9.88, P<0.01) were the dominant vacA gene subtypes in the H. pylori isolates. The dominant H. pylori genotype was cagA+s1a/m2 (59.0% from antrum specimens and 57.1% from corpus specimens), and followed by cagA+s1a/m1b (28.9% from antrum specimens and 27.4% from corpus specimens). Sixteen of 78 patients (20.5%) were infected with two or three H. pylori strains with different genotypes. However, no statistically significant differences among cagA occurrence, the different vacA subtypes and PU or CG could be found (each P>0.05). Similarities of the nucleotide sequences from vacA gene s region PCR products of six isolates and from vacA gene m region PCR products of four isolates were 93.2% to 98.3% and 93.8% to 97.6%, respectively, compared to the reported corresponding sequences.Conclusions The dominant genotypes of H. pylori in PU or CG patients in Zhejiang area may be cagA+ s1a/m2 and cagA+ s1a/m1b. Numerous coinfections with different H. pylori strains in PU or CG patients indicate diversity of the infected H. pylori origins. s and m regions of vacA gene from different H. pylori isolates show high nucleotide sequence similarities. cagA gene positive rate, different vacA gene subtypes and coinfection with different H. pylori strains are not closely associated with severity of the diseases.  相似文献   

4.
In this study,the colonization and distribution of Helicobacter pylori(Hp) in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of Hp in oral cavity was examined to better understand the connection between Hp infection and chronic diseases.Primers for PCR amplification were designed according to ureC gene and cagA genes of Hp.Specimens were harvested from different sites of 96 patients with chronic gastric diseases and the specimens of dental plaques,gargles and dorsal mucosa were tested for Hp.The 96 patients were treated by bismuth triple therapy and among them,52 subjects were additionally given periodontal initial therapy.The eradication rate of gastric Hp and oral Hp detection rate were determined 4 weeks and 1 year after the treatment.The results showed that the detection rates of oral specimens were in the order of dental plaques(82.3%),gargles(51.1%) and scrapings of dorsal mucosa of tongue(37.5%).One year after bismuth triple therapy or the triple therapy in combination with periodontal initial treatment,the eradication rate of gastric Hp was significantly higher in the combination treatment group than in group treated by the triple therapy alone(62.8% vs.32.4%,P<0.05).Moreover,the Hp detection rate was significantly lower in the combination group than in the group treated only with the triple therapy.We are led to conclude that Hp is present at various parts of oral cavity,oral Hp might be an important source of gastric Hp and the triple therapy plus periodontal initial treatment can enhance the long-term eradication rate of gastric Hp in patient with both chronic gastric diseases and chronic periodontitis.  相似文献   

5.
Helicobacter pylori (H. pylori) infection is a common etiological factor leading to chronic gastritis and peptic ulcer. In addition, there is a close relationship between H. pylori infection and non-ulcer dyspepsia or gastric cancer. The high incidence of H. pylori infection in pediatric patients in developing countries is thought to inhibit their physical development because of malnutrition, anaemia and growth retardation. Anti-H. pylori therapy is recommended in children with H. pylori-induced gastritis and ulcer. The intake of high-dose broad-spectrum antibiotics may cause serious side effects including the alteration of intestinal flora, fungal infection, impaired liver function, and drug resistance. In recent years, simultaneous administration of probiotics has been used to alleviate the side effects of drug therapy and boost the therapeutic effectiveness of H. pylori eradication. In this study, we investigated changes in the intestinal microbial flora in H. pylori infected children and after H. pylori eradication therapy. We attempted to establish a basis for future research into the role of probiotics in anti- H. pylori treatment.  相似文献   

6.
Background The prevalence of Helicobacterpylori (H. pylon) infection varies by geographic locations. Studies indicate that the infection rate of H. pylori was previously high in China but that rates had been declining worldwide over recent decades. The aims of our study were: (1) to determine the current prevalence of H. pylori infection among children and adults residing in areas with high (Muping County, Shandong) and low (Yanqing County, Beijing) incidences of gastric cancer in China, and (2) to compare the prevalence for 2006 with the prevalence for the early 1990s. Methods Using Warthin-Starry silver staining of gastric mucosal biopsy specimens and H. pylori stool antigen tests (HpSA), we tested a total of 2065 asymptomatic children aged 8-15 years and adults aged 40-79 years in the above two regions from May to July 2006. We evaluated 520 children and 526 adults from Muping, and 516 children and 503 adults from Yanqing. Subjects were selected randomly and H. pylori status was determined by HpSA in children and either HpSA or histology of gastric biopsies in adults. Data obtained in the early 1990s in the same two areas of China were also collected and studied. Results For children, the prevalence of H. pylori infection was significantly higher in Muping (37.69%) than it was in Yanqing (25.58%, P〈0.001). In both regions, the prevalence of H. pyloriincreased with age but was not related to gender A significant difference was observed between 8-9-years old and 10-11-years old (P 〈0.05), but not between other adjoining age groups (P 〉0.05). From 1991 to 2006 H. pylori prevalence among 8-10-year-old children decreased in Muping (60.00% vs 32.07%, P 〈0.001), but not Yanqing (24.06% vs 19.10%, P 〉0.05). In the adult group, H. pylori prevalence was 50.95% in Muping, which was significantly higher than the 41.35% positive rate in Yanqing (P 〈0.01). But there were no statistically significant differences between different age groups of 40-49, 50-59, and 60-79 years, or between males and females. A significant decrease in H. pylori prevalence in both regions was observed when the results of 2006 were compared with the data obtained in 1990 in Muping (50.95% vs 73.78%, P 〈0.001) and in 1992 in Yanqing (41.35% vs 55.35%, P〈0.01). Conclusions After fifteen years, the prevalence of H. pylori infection among both children and adults remained significantly higher in areas with a high incidence of gastric cancer in China compared with that in areas with a low incidence of gastric cancer. H. pylori infection rates have decreased in the general Chinese population during recent years.  相似文献   

7.
Objective To determine the role of Helicobacter pylori ( Hp ) in the development of gastric cancer and gastric precancerous lesions. Methods From the biopsy specintestinal metaplasiaens of gastric cancer and precancerous lesions lip organisms were detected by a combination use of three methods ( Clo-test,Giemsa and PCR ). Mutations of C-Ha-ras and p53 genes were determined by polymerase chain reaction-single strand conformation polymorphism analysis-direct sequencing ( PCR-SSCP-S ) . Results The detection rates of lip in gastric cancer, dysplasia and intestinal metaplasia were significantly higher than that of normal gastric mucosa , and the mutational rates of C-Ha-ras and p53 genes in Hp positive patients were significantly higher than those in lip negative patients. In gastric cancer patients, the mutational rate of p53 gene in lip positive patients was significantly higher than that of lip negative patients, in which spot mutation was the main pattern of gene changes.Conclusion Hp infection might be related to gastrocarcinogenesis and gene mutation might play a role in Hp related gastric cancer.  相似文献   

8.
Objective This article aimed to review the incidence of Helicobacterpylori (H.pylon) infection and its therapy.Data sources Relevant articles published in English were identified by searching in PubMed from 2000 to 2013,with keywords "H.pylori".Important references from selected articles were also retrieved from Elsevier,Wiley,EBSCO,and SPRINGER.The Chinese articles published were searched from China National Knowledge Infrastructure (CNKI).Study selection Articles about "prevalence","gastric carcinoma","peptic ulcer","gastroesophageal reflux disease","functional dyspepsia","pathogenic mechanism","therapy","eradication rate","antibiotic resistance",and "gene polymorphisms" were selected.Results The decreased infection rates of H.pylori could also be linked to the changed disease spectrum,such as the decreased morbidity and recurrence rate of H.pylori-related peptic ulcer,and the increased morbidity of gastroesophageal reflux.Although different treatment regimens have been used for H.pylori infection,the H.pylori eradication rate declined gradually.Due to primary resistance to antibiotics,the gene polymorphism of host and infected strain,and the therapy regimes,H.pylori eradication became even more difficult.Conclusions The prevalence of H.py/ori infection had been decreasing,but the rate of eradication failure has dramatically risen in many countries due to resistance to antibiotic.H.pylori therapy in clinical practice is becoming proqressively more difficult.  相似文献   

9.
The development of gastric cancer is a multi-factor process.In addition to genetic factors,environmental factors including smoking,low gastric acidity,excessive intake of salt or salty food and low consumption of fresh fruits and vegetables all contribute to the development of gastic cancer.Of particular interest,epidemiological and experimental studies have demonstrated that Helicobacter pylori(H.pylori)infection is causally linked to gastric cancer.Most studies using micronutrient supplementation have failed to demonstrate any preventive effect against the development of gastric cancer.The use of non-steroidal antiinflammatory drugs has been consistently observed to protect against the development of gastric cancer. Recently,eradication of H.pylori infection by a chemopreventative approach is being studied in a number of trials.Studies using precancerous lesions as an end point of the treatment have produced conflicting and mostly negative results.Trials using cancer as an end point are being cautiously carried out in high-risk populations,and will provide the definitive answer to this important question.In the end,vaccination may be proven to be the optimal strategy in human for the management of H.pylori infection and prevention of gastric cancer.  相似文献   

10.
Objective: To investigate whether three strains of probiotics, L. acidophilus, L. rhamnosus, and L. sporogenes, had significant inhibitive effects on Helicobacter pylori(H. pylori). Methods: This is a 4-week, randomly assigned, parallel-group, doubled-blind, and placebo-controlled study. Fifty patients with a positive H. pylori infection urea breath test(△UBT) result 10% and without ulcer symptoms were randomized into a treatment group and a placebo group by a computer generated allocation sheet with 1:1. These subjects took one capsule of probiotics or placebo twice daily. The primary measurement was the change in △UBT values. Results: The △UBT values during the 4-week treatment period and the 2-week follow-up period were not significantly different between the treatment group and the placebo group, indicating that the inhibitive effects on H. pylori were comparable between both groups. The monocyte count(%) was 5.77±1.11 in the treatment group versus 5.09±1.12 in the placebo group(P=0.044), and the basophile count was 0.55±0.32 in the treatment group versus 0.36±0.23 in the placebo group(P=0.024) at week 2 of the treatment period, both of which reached statistical significance. The monocyte count was 5.75±1.26 in the treatment group and 4.72±0.99 in the placebo group at the end of the follow-up period(P=0.003). Conclusions: There was no significant inhibitive effects of the three probiotic strains(L. acidophilus, L. rhamnosus, and L. sporogenes) on H. pylori. Probiotics can not play the same role as antibiotics in the eradication of H. pylori, the role of probiotics is likely to be important as adjuvant to the triple or quadruple therapy for H. pylori, especially in resistance cases.  相似文献   

11.
Background: The incidence and mortality from gastric cancer is high in Japanese but extremely low in Thailand. It is different among Asian countries. The aim of this study is to investigate the difference of peptic ulcer disease, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis between the Nepalese and Japanese population. Materials and methods: Nepalese patients were paired with Japanese patients by age, gender and endoscopic diagnosis in order to compare the prevalence of H. pylori infection (N=309) and the difference of H. pylori related peptic ulcer disease (N=48). Glandular atrophy and intestinal metaplasia scores were also compared between the Nepalese and Japanese population in H. pylori positive cases (N=152) and negative cases (N=145) using paired cases by age, gender and endoscopic diagnosis. Paired H. pylori-positive Nepalese and Japanese population were also used to compare the ratio of corpus gastritis to antrum gastritis (C/A ratio) (N=152). Results: Among peptic ulcer diseases, gastric ulcer was frequent in Japanese and duodenal ulcer was frequent in Nepalese. The prevalence of H. pylori infection in the Nepalese and Japanese population were similar. Glandular atrophy and intestinal metaplasia scores in the H. pylori positive Japanese were significantly higher than those of Nepalese in all positions according to triple site biopsy. Furthermore, there were significant differences in glandular atrophy and intestinal metaplasia scores between in the H. pylori-negative Nepalese and Japanese population except intestinal metaplasia score in the greater curvature of the upper corpus. Japanese C/A ratio was significantly higher than that of Nepalese. Corpus predominant gastritis (C/A ratio>1.00) was characteristic in the elderly Japanese. Nepalese was antrum predominant (C/A ratio<1.00) in every age group. Conclusions. Gastric ulcer was a common disease in Japanese, in contrast duodenal ulcer was common in Nepalese. H. pylori infected Japanese patients showed severe atrophic and metaplastic gastritis in comparison with Nepalese. These results may be associated with the high incidence of gastric cancer in Japanese. Corpus predominant gastritis was found in the elderly Japanese and antrum predominant gastritis was found in every age Nepalese. Key words: H. pylori, atrophy, metaplasia, corpus-predominant gastritis, Nepal.  相似文献   

12.
目的探讨清除幽门螺杆菌后对胃黏膜病变转归的影响。方法人选患者均经胃镜和临床病理诊断为慢性胃炎、萎缩性胃炎伴肠上皮化生,并确定有Hp感染的状态。患者分两组:幽门螺杆菌根治组慢性胃炎42例、萎缩性胃炎伴肠上皮化生45例,未行Hp治疗组慢性胃炎41例、萎缩伴肠上皮化生38例;于根除幽门螺杆菌后1年行胃镜随访,在同一部位取活检,根据病理结果的不同分为好转和无好转。结果治疗Hp1年后慢性胃炎根治组逆转率54.52%(23/42),未根治组19.51%(8/41),组间比较有非常明显差异(χ^2=11.06,P〈0.01);Hp根治组萎缩性胃炎伴肠上皮化生病变逆转率15.56%(7,45),未根治组10.53%(4/38),组间比较无明显差异。结论根除Hp1年后慢性胃炎病变有明显好转,对萎缩性胃炎伴肠上皮化生病变无明显影响。  相似文献   

13.
目的 通过对幽门螺旋杆菌(Helicobacter Pylori,H.pylori)阳性的胃黏膜肠上皮化生(intestinal metaplasia,IM)患者进行前瞻性的随访研究,明确根除H.pylori能否在一定程度上逆转IM,以及根除H.pylori对IM发生、发展的影响,为预防肠型胃癌的发生以及根除H.pylori最佳时机的选择提供一定的参考。 方法 收集2017年4月1日—2018年4月1日在温州医科大学附属第二医院内镜中心行胃镜检查,并经证实存在H.pylori感染和胃黏膜肠上皮化生者共280例,按照患者意愿及肠化病理轻重情况,将其分为根除H.pylori组及未根除H.pylori组(对照组),比较2组间轻、中、重度IM患者分别随访6个月及12个月的病理学改变的差异。 结果 随访6个月及12个月均发现,轻、中度IM患者根除H.pylori后IM程度较未根除H.pylori患者减轻(P<0.05),而重度IM患者根除H.pylori后IM程度与未根除H.pylori患者之间差异无统计学意义(P>0.05)。 结论 胃黏膜轻、中度IM患者若发现H.pylori感染,应尽早予以根除,此时可能为根除H.pylori的最佳时机。   相似文献   

14.
目的探讨根除幽门螺杆菌(H.pylori)慢性感染对胃黏膜炎症和肠上皮化生(IM)的意义。方法随访150例2~6年前H.pylori感染的患者,其中83例行根除H.pylori治疗(治疗组),67例未完成治疗或仅接受对症治疗(对照组),分析对比其前后H.pylori感染情况、胃黏膜炎症及IM的变化情况。结果2~6年后,对照组中52例H.pylori呈阳性(78.8%);治疗组中20例H.pylori呈阳性(23.5%),胃炎活动性检出率明显减少,与对照组持续H.pylori感染者比较,差异有显著性(P<0.01),胃黏膜萎缩和肠化生的程度也显著减轻(P<0.05)。结论H.pylori感染与胃黏膜活动性炎症关系非常密切,根除H.pylori可以减轻胃黏膜的炎症和IM程度。  相似文献   

15.
CagA阳性幽门螺杆菌感染与上胃肠道疾病关系的研究   总被引:6,自引:2,他引:4  
目的探讨CagA阳性幽门螺杆菌(Hp)感染与上胃肠道病变的关系;并观察Hp根除治疗后血清中抗CagAIgG抗体水平的变化.方法808例因上胃肠道症状而接受胃镜检查的病人,同时作Hp检查.对Hp感染者用ELISA方法检测血清中抗CagAIgG抗体;阳性者予含质子泵抑制剂(PPI)三联疗法根除治疗.其中60例根除治疗失败病人和120例根除成功病人在Hp根除治疗结束3个月和6个月时复查血清中抗CagAIgG抗体水平.结果在不同临床疾病中,慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、胃溃疡(GU)、十二指肠溃疡(DU)和胃癌(GC)感染Hp的病人中抗CagAIgG抗体阳性率分别为55.4%、70.5%、83.2%、90.8%、89.7%.后4组阳性率明显高于CSG组,后3组均明显高于CAG组;在不同程度的胃粘膜病变中,CSG、CAG、肠上皮化生(IM)、非典型增生(Dys)和GC感染Hp的病人中抗CagAIgG抗体的阳性率分别为43.0%、53.8%、77.6%、88.6%、89.7%.IM、Dys和GC组均明显高于CSG和CAG组;60例根除失败者在治疗前及治疗后3个月和6个月时血清中抗CagAIgG水平分别为(72±41)U/ml,(67±36)U/ml和(69±40)U/ml,治疗前后差异无显著意义,无一例转为阴性;120例根除治疗成功者治疗后3个月和6个月血清中抗CagAIgG水平平均由(69±38)U/ml分别下降至(47±30)U/ml和(32±15)U/ml,治疗后与治疗前比较差异均有显著意义,在治疗后3个月和6个月时分别有7.5%(9/120)和19.2%(23/120)的病人抗体转为阴性.结论CagA阳性的Hp可能导致更严重的上胃肠道疾病和更严重的胃粘膜病变;Hp根除治疗后血清中抗CagAIgG抗体水平明显下降,但下降较慢,不宜作为个体监测疗效的指标.  相似文献   

16.
目的 回顾性分析胃黄色瘤(gastric xanthoma, GX)合并肠上皮化生患者的临床特征。方法 选取2012年1月至2022年1月在首都医科大学宣武医院消化内镜中心初次行胃镜检查的患者共68 391例,诊断GX 1 346例,GX检出率为1.97%,平均年龄为(55.4±12.1)岁。根据有无肠上皮化生(以下简称肠化)将GX分为2组:GX伴肠化组(n=901)和GX不伴肠化组(n=445)。对比两组患者的年龄、性别、幽门螺杆菌(Helicobacter pylori,HP)感染、胃黏膜萎缩程度及是否合并胃癌情况。将GX伴肠化组再根据肠化的程度分为3个亚组:GX伴轻度肠化(n=412)、GX伴中度肠化(n=291)和GX伴重度肠化(n=198),对比分析不同亚组GX伴肠化的临床特征。结果 GX伴肠化与GX不伴肠化组在年龄(P=0.012)、HP感染(P<0.001)和是否合并胃癌(P=0.014)方面差异有统计学意义;GX伴肠化组中年龄≥65岁患者发病率较高、HP感染率高、合并胃癌的检出率较高。单因素及多因素分析显示GX患者中胃癌组和非胃癌组在年龄(P<0.001)、...  相似文献   

17.
目的 CyclinD和CyclinE的异常表达常引起细胞周期调节异常而导致肿瘤。为阐明这些Cyclin基因在人体胃癌发生、发展过程中的作用 ,本文对 38例胃癌患者、2 9例胃癌的第一代亲属及 18例健康对照者进行了研究。方法 本研究对上述不同组别及相应的病理组织学表现 ,包括肠化生、萎缩、HP感染及胃炎的状况进行了Cyclin基因表达的研究 ,采取逆转录聚合酶链反应 (RT PCR)的方法。结果 胃癌组织中CyclinD2、D3和E的表达相对于癌旁正常组织明显增高 ,并且CyclinD2和D3的增高表达也发现于胃癌的第一代亲属中 (P <0 0 5 )。不同病理组织学改变 ,肠化生组织CyclinD2、D3和E的表达明显增高 ,胃粘膜萎缩仅CyclinD3表达增高 ,HP感染较未感染组CyclinD2、D3表达增高。但CyclinD1的表达状况与病理组织学改变无关。结论 本研究提示增高的CyclinD2、D3和E是胃癌变过程中的一个常见和早期事件 ,并且基因的异常表达可出现于胃癌患者的第一代亲属中。CyclinD1的表达与胃癌变过程中的临床及病理学变化无明显关系。  相似文献   

18.
董书琪  毛雅琴  程浩  姚云斌  高敏 《浙江医学》2015,37(22):1846-1848
目的建立国内幽门螺杆菌(Hp)流行株的动物模型,研究Hp流行株感染小鼠的胃黏膜改变,为进一步治疗提供更好的动物模型。方法60只SPF级C57BL/6小鼠,分为正常组和模型组,每组30只。模型组经口灌服VacAs1、CagA、iceA阳性的临床分离株,距末次灌胃后5、10、15、20、25、30周分6批处死,取标本行快速尿素酶试验,Giemsa染色法观察Hp在胃黏膜上的定植情况,HE染色观察小鼠胃黏膜的病理变化。结果正常组小鼠的胃窦、胃体及十二指肠黏膜的尿素酶试验,Giemsa染色结果均阴性,模型组在距末次灌胃后5、10、15、20、25、30周Hp定植率分别为60%、80%、100%、100%、100%、100%。至30周模型组慢性浅表性胃炎、慢性萎缩性胃炎、肠化、异型增生、胃癌发生率分别为100%、60%、0%、0%、0%。结论成功建立了HpVacAs1、CagA、iceA阳性的国内流行株感染C57BL/6小鼠的模型,并明确了其感染小鼠后各阶段的胃黏膜病理改变。  相似文献   

19.
目的 探讨血清胃蛋白酶原(PG)、促胃液素-17(G-17)和幽门螺杆菌抗体对胃癌前状态的诊断效能.方法 收集331例慢性胃炎患者,观察胃黏膜萎缩、肠化、上皮内瘤变以及不同OLGA/OLGIM分期患者的血清PG和G-17水平的变化以及ABC法各组中胃癌前状态的发病情况.结果 ①胃窦萎缩患者的血清G-17水平低于无萎缩(P =0.030),胃体萎缩患者的血清PG Ⅰ/PGⅡ比值(PGR)水平低于无萎缩(P =0.046),全胃萎缩患者的血清PG Ⅰ(P=0.036)及PGR(P=0.030)水平低于无萎缩;②胃窦肠化患者的血清G-17水平低于无肠化(P =0.021),全胃肠化患者的血清PG Ⅰ水平低于无肠化(P =0.015);③全胃低级别上皮内瘤变患者的血清PG Ⅰ水平低于无低级别上皮内瘤变(P=0.036);④OLGA分期中血清PG Ⅰ水平随分期严重程度加重逐渐降低,以Ⅳ期降低明显(P=0.035);⑤OLGIM分期中血清PGⅠ水平随分期严重程度的加重逐渐降低,以Ⅳ期降低明显(P=0.018);⑥“ABC法”分组中,尽管高危组中发生胃癌前状态的患者占组内人数的比例较低危组高,但低危组中仍有50.16%的患者为慢性萎缩性胃炎以及15.96%的患者为低级别上皮内瘤变.结论 血清PG和G-17可以作为胃癌前状态发生风险的临床筛查指标,ABC法对早期胃癌具有筛查作用,但低危组人群仍存在发生胃癌前状态的风险.  相似文献   

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