冠状动脉狭窄程度与冠心病危险因素的相关性分析

目的探讨冠状动脉狭窄程度与冠心病危险因素的相关性。方法连续性收集我科行冠状动脉造影的患者121例,根据造影结果,将患者分为冠心病组89例与对照组32例。收集2组患者临床、实验室和影像学资料,采用单因素和多因素logistic回归模型进行分析。结果冠心病组男性、糖尿病、吸烟比例和LDL-C水平均高于对照组,HDL-C水平低于对照组(P<0.05);多因素logistic回归分析示,糖尿病(OR=3.769,P=0.042)、LDL-C水平(OR=1.873,P=0.021)是冠心病的独立危险因素。中、重度冠状动脉狭窄患者吸烟比例均高于轻度狭窄者,中度狭窄患者男性比例、年龄与尿酸水平和重度狭窄患者高血压、糖尿病比例均高于轻度狭窄者,差异均有统计学意义(P<0.05);logistic回归分析示,年龄(OR=1.094,P=0.001)、高血压(OR=3.340,P=0.003)、糖尿病(OR=3.877,P=0.003)和吸烟(OR=4.536,P=0.003)与冠状动脉狭窄程度相关。结论冠心病的危险因素与冠状动脉狭窄程度存在显著相关性,其中糖尿病是两者共同的重要危险因素。     

糖尿病患者合并结直肠癌的危险性分析

目的探讨糖尿病患者合并结直肠癌的癌变危险因素及相关性。方法选取500例结直肠癌患者及1 500例非恶性肿瘤患者作为研究对象,采取病例对照分析法,对所有研究对象进行单因素危险性分析。结果结直肠癌患者中糖尿病病发率,非结直肠癌患者中糖尿病病发率为;糖尿病患者合并结直肠癌的危险性显著高于非糖尿病患者(OR=3.99,P0.01);随着糖尿病病程延长,糖尿病患者合并结直肠癌的危险性逐渐增加,糖尿病病程小于4年,4~8年及大于8年合并结直肠癌的危险性均显著高于非糖尿病患者(OR分别为3.99,P均小于0.05);糖尿病患者合并结直肠癌处于进展期比率为51.61%(32/62),显著高于非糖尿病的结直肠癌患者的27.85%(122/438);两组数据差异有统计学意义(x2=16.74,P0.05);糖尿病患者合并结直肠癌发生血行转移及淋巴转移比率为48.39%(30/62),显著高于非糖尿病的结直肠癌患者的22.83%(100/438);两组数据差异有统计学意义(x2=15.87,P0.05)。结论糖尿病可作为结直肠癌的独立危险因素,而结直肠癌的危险性与糖尿病病程呈正相关性,而糖尿病可促进及恶化结直肠癌的病情。     

2型糖尿病患者结直肠腺瘤临床病理特征和进展期腺瘤危险因素分析

背景:结直肠腺瘤为结直肠癌的癌前病变,糖尿病可增加结直肠癌发生风险。目的:探讨2型糖尿病患者结直肠腺瘤的临床病理特征以及进展期腺瘤的危险因素。方法:回顾性连续收集2018年1月—2020年12月在浙江中医药大学附属第二医院初次行全结肠镜检查者,227例2型糖尿病结直肠腺瘤患者、553例2型糖尿病无息肉患者和与2型糖尿病腺瘤组1∶1匹配[匹配因素包括性别、年龄、体质指数(BMI)和吸烟史]的227例非糖尿病结直肠腺瘤患者纳入研究。总结2型糖尿病结直肠腺瘤患者的临床和病理特点,采用单因素和多因素分析筛选进展期腺瘤的危险因素。结果:与2型糖尿病无息肉组相比,2型糖尿病腺瘤组年龄更大,男性、吸烟者和有胆囊结石/胆囊切除史者比例更高(P均0.05)。与非糖尿病腺瘤组相比,2型糖尿病腺瘤组多发腺瘤和进展期腺瘤比例更高(16.7%对10.1%,21.6%对14.1%,P均0.05)。多因素Logistic回归分析显示,男性(OR=1.299,95%CI:1.041～1.831,P=0.008)、年龄(OR=1.129,95%CI:1.001～1.421,P=0.025)、BMI(OR=1.118,95%CI:1.022～1.715,P=0.038)和2型糖尿病(OR=1.408,95%CI:1.141～1.721,P=0.010)是进展期腺瘤的独立危险因素。结论:2型糖尿病患者有更高的结直肠多发腺瘤和进展期腺瘤检出率,男性、年龄、BMI和2型糖尿病与进展期腺瘤显著相关。     

胃癌、结直肠癌患者以慢性贫血为首发表现的危险因素分析

[目的]探讨无明显消化道症状以慢性贫血为首发表现的胃癌、结直肠癌患者危险因素。[方法]回顾性搜集2015-06-2018-06期间以慢性贫血为首发表现的胃癌、结直肠癌患者72例的临床资料,采用χ~2检验和Logistic回归分析癌患者与性别、年龄、计算机断层扫描(CT)、肿瘤标志物、病理特征的相关性。[结果]①72例中,胃癌39例(54.2%),结直肠癌33例(45.8%)。39例胃癌患者中男25例,女14例,平均年龄(67.6±11.5)岁;33例结直肠癌患者中男19例,女14例,平均年龄(62.4±13.0)岁。②χ~2检验结果显示,胃癌患者中以慢性贫血为首发症状者与非慢性贫血者的年龄、CT表现、肿瘤分期、大便潜血上比较差异有统计学意义(P0.05～0.01);结直肠癌患者中以慢性贫血为首发症状者与非慢性贫血患者在肿瘤部位、肿瘤直径、大便潜血、血清CEA、血清CA199上比较差异有统计学意义(P0.05～0.01)。③二分类Logistic回归分析结果显示,无明显消化道症状的胃癌患者中,年龄≥60岁、CT阳性、Ⅲ/IV期、大便潜血阳性的慢性贫血风险高;无明显消化道症状的结直肠癌患者中,右半结肠、肿瘤直径≥5 cm、大便潜血阳性、血清CEA阴性、血清CA199阴性的慢性贫血风险高。[结论]无明显消化道症状的胃癌患者年龄、CT表现、肿瘤分期、大便潜血是发生慢性贫血的危险因素,无明显消化道症状的结直肠癌患者肿瘤部位、肿瘤直径、大便潜血、肿瘤标志物是慢性贫血的危险因素,当患者合并高危因素时应考虑到消化道恶性肿瘤可能。     

性别对80岁以上高龄急性冠脉综合征患者长期预后的影响

目的探讨性别对≥80岁高龄急性冠脉综合征(ACS)患者长期预后的影响。方法连续入选解放军总医院心内科自2006年1月至201 1年12月≥80岁行冠状动脉造影检查的ACS患者664例(女性占28.31%)。根据性别进行分组,对两组患者的临床资料结果进行比较分析,记录患者主要不良心脏事件(MACE),Kaplan-Meier生存曲线分析性别对高龄ACS患者长期生存率的影响。Cox多因素回归分析影响长期预后的独立危险因素。结果随访周期13~79个月(中位数28个月)。女性患者高脂血症患病率、左室射血分数、体质量指数及空腹血糖水平高于男性患者(P0.05)。男性患者舒张压、血尿酸水平、吸烟史、慢性肾功能不全、陈旧性心肌梗死、脑卒中发病率高于女性患者(P0.05)。两组患者的ACS临床分型、用药方案及治疗策略未见显著差异(P0.05)。Kaplan-Meier生存曲线分析显示,两组患者长期生存率(P=0.619)及无事件生存率(P=0.365)均无显著差异。Cox多因素回归分析显示非高密度脂蛋白胆固醇(non-HDL-C)、收缩压水平是高龄ACS患者全因死亡(HR=1.73,95%CI:1.09~2.75,P=0.019;HR=0.98,95%CI:0.97~1.00,P=0.015)和MACE发生(HR=1.80,95%CI:1.22~2.63,P=0.003;HR=0.98,95%CI:0.97~0.99,P=0.003)的独立危险因素。结论性别不是影响高龄ACS患者长期预后的危险因素,non-HDL-C和收缩压水平是该人群的全因死亡和MACE发生的独立危险因素。     

老年结直肠癌腹腔镜手术患者术后肠梗阻发生率及影响因素

目的探讨老年结直肠癌腹腔镜手术患者术后肠梗阻的发生率及影响因素。方法选择2013年1月至2017年2月在该院进行腹腔镜手术治疗的老年结直肠癌患者288例为研究对象,术后至少随访30 d,记录术后肠梗阻的发生率;根据术后是否发生肠梗阻分为肠梗阻组和非肠梗阻组,采用单因素和多因素logistic回归分析法分析其影响因素。结果 288例老年结直肠癌腹腔镜手术患者,术后30 d内肠梗阻的发生率为6.25%(18/288);单因素分析显示:性别、年龄、术前肠梗阻、肿瘤位置、TNM分期、吸烟史、腹部手术史、手术时间、肿瘤分化程度等是老年结直肠癌腹腔镜手术术后肠梗阻发生的影响因素(P0.05);多因素分析显示:男性、年龄≥70岁、术前有肠梗阻、直肠癌、TNM分期为Ⅲ～Ⅳ期及手术时间≥2 h是老年结直肠癌腹腔镜手术术后肠梗阻发生的危险因素(P0.05)。结论老年结直肠癌腹腔镜手术患者术后肠梗阻的危险因素较多,医护人员应采取相应的预防措施,尽可能降低术后肠梗阻的发生率,提高治疗水平。     

主动脉弓钙化对女性患者冠心病的预测价值

目的探讨主动脉弓钙化(aortic arch calcification,AAC)对女性患者冠心病的预测价值。方法入选2015年1月至2015年4月在韶关市粤北人民医院心血管内科行冠状动脉造影检查的患者305例,其中男性216例,女性89例。使用胸部前后位X光片评价AAC发生情况,并根据结果将不同性别患者分别分为钙化组与非钙化组,比较不同性别钙化组与非钙化组患者冠心病危险因素发生情况。采用二分类Logistic回归分析冠心病危险因素。结果对不同性别患者,钙化组患者年龄均较非钙化组患者增大(P0.05);女性钙化组患者较非钙化组患者合并高血压,高脂血症比例增高(P0.05),而男性钙化组患者较非钙化组患者合并糖尿病比例增高(P0.05)。Logistic回归分析显示,女性患者中,年龄(OR:1.097,95%CI:1.019~1.181,P=0.014)和AAC(OR:3.202,95%CI:1.047~9.789,P=0.041)是冠心病发生的独立危险因素,而男性患者中,年龄(OR:1.053,95%CI:1.017~1.090,P=0.004)和高脂血症(OR:2.172,95%CI:1.055~4.474,P=0.035)是冠心病发生的独立危险因素。结论胸部前后位片检测的AAC是预测女性冠心病的重要指标。     

结直肠腺瘤发生和复发的危险因素分析

目的 探究结直肠腺瘤发生和复发的危险因素,以期优化筛查及随访方案。方法 回顾性收集2018年1月至2020年12月在上海市嘉定区中心医院接受结肠镜检查且病理结果示结直肠腺瘤患者的临床资料,根据纳入和排除标准,共入组623例患者。根据基线结肠镜检查报告及腺瘤的病理检查结果,将患者分为高危腺瘤组和非高危腺瘤组,比较2组的年龄、性别、吸烟史、饮酒史和复发情况。采用单因素和多因素logistic回归模型分析结直肠高危腺瘤发生及结直肠腺瘤复发的危险因素。结果 本研究总计纳入1 125枚结直肠腺瘤,其中进展期结直肠腺瘤430枚,非进展期结直肠腺瘤695枚,两者在分布位置方面差异无统计学意义（P>0.05）。高危腺瘤组（277例）和非高危腺瘤组（346例）均以男性较为多见,2组在性别、饮酒史方面的差异无统计学意义（P=0.14,P=0.13）。与非高危腺瘤组比较,高危腺瘤组中有吸烟史患者的占比较高、平均年龄较高、复发率较高,差异均有统计学意义（P均<0.01）。多因素logistic回归模型分析结果显示,年龄≥50岁是结直肠高危腺瘤发生的独立危险因素,吸烟史、高危腺瘤是结直肠腺瘤复发的独...     

结直肠癌患者术后吻合口瘘发生的危险因素分析

目的分析结直肠癌患者术后吻合口瘘发生的危险因素。方法对该院2006-01～2018-06行结直肠癌根治术治疗的459例患者临床资料进行回顾性分析,采用单因素和多因素Logisitc回归分析探讨术后吻合口瘘发生的危险因素。结果吻合口瘘发生率为9.80%(45/459)。多因素Logistic回归分析结果显示年龄(OR=2.815)、术前合并糖尿病(OR=4.872)、术前合并低蛋白血症(OR=3.258)、肿瘤距肛门缘距离(OR=4.153)是结直肠癌术后吻合口瘘发生的危险因素。结论年龄、术前合并糖尿病、术前合并低蛋白血症、肿瘤距肛门缘距离是结直肠癌术后吻合口瘘发生的危险因素,围术期应充分考虑这些因素的影响,并采取适当的预防措施。     

肾功能不全与老年急性非ST段抬高型心肌梗死死亡率的相关性分析

目的探讨老年急性非ST段抬高型心肌梗死(NSTEMI)合并肾功能不全对住院死亡率的影响。方法选取2015年6月～2018年10月本院收治的176例老年NSTEMI患者作为研究对象,按有无合并肾功能不全分为肾功能不全组(n=49)及无肾功能不全组(n=127),logistic回归分析两组患者年龄、性别、冠心病史、高血压病史、糖尿病病史等基础临床资料相关的危险因素。结果两组性别、既往高脂血症、年龄、吸烟史、冠心病史及有无PCI治疗差异不显著(P0.05),而肾功能不全患者出现合并有高血压、合并有糖尿病及入院高心功能分级的几率更大(P0.05),与无肾功能不全组相比,肾功能不全患者的住院死亡率更高(P=0.001)。结论肾功能不全与入院高心功能KILLIP分级是老年非ST段抬高型心肌梗死住院死亡的独立预测因素。     

Prevalence of Entamoeba histolytica in patients with schistosomal colonic polyposis

Two hundred and fifty-seven Egyptian patients were classified into three groups: patients with schistosomal colonic polyposis, those with simple schistosomiasis without polyposis, and a non-schistosomal group. A diagnosis of schistosomiasis was made by clinical history and examination plus three fresh stool examinations or a rectal biopsy. The presence of schistosomal colonic polyps was established by sigmoidoscopy and biopsy of polyps. Stool examinations were made on all individuals, using the merthiolate-iodine-formaldehyde technique to detect Entamoeba histolytica. We found the prevalence of amebiasis in the group with schistosomal colonic polyposis (37%) to be significantly higher than that in the non-schistosomal group (11%) and in the schistosomal group without polyposis (15%). The difference in prevalence of amebiasis between the simple schistosomal and non-schistosomal groups was not significant.     

Comparison of non-schistosomal rectosigmoid cancer and schistosomal rectosigmoid cancer

AIM: To compare the clinicopathological features of patients with non-schistosomal rectosigmoid cancer and schistosomal rectosigmoid cancer.METHODS: All the patients with rectosigmoid carcinoma who underwent laparoscopic radical surgical resection in the Shanghai Minimally Invasive Surgical Center at Ruijin Hospital affiliated to Shanghai Jiao-Tong University between October 2009 and October 2013 were included in this study. Twenty-six cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected. Symptoms, endoscopic findings and clinicopathological characteristics were evaluated retrospectively.RESULTS: There were no significant differences between patients with and without schistosomiasis in gender, age, CEA, CA19-9, preoperative biopsy findings or postoperative pathology. Patients with rectosigmoid schistosomiasis had a significantly higher CA-125 level and a larger proportion of these patients were at an early tumor stage (P = 0.003). Various morphological characteristics of schistosomiasis combined with rectosigmoid cancer could be found by colonoscopic examination: 46% were fungating mass polyps, 23% were congestive and ulcerative polyps, 23% were cauliflower-like masses, 8% were annular masses. Only 27% of the patients were diagnosed with rectal carcinoma preoperatively after the biopsy. Computed tomography (CT) scans showed thickened intestinal walls combined with linear and tram-track calcifications in 26 patients.CONCLUSION: Rectosigmoid carcinoma combined with schistosomiasis is associated with higher CA-125 values and early tumor stages. CA-125 and CT scans have a reasonable sensitivity for the accurate diagnosis.     

结直肠息肉、结直肠癌的特点及与幽门螺杆菌感染相关性的研究

目的 探讨结直肠息肉、结直肠癌临床与病理的特点及其与幽门螺旋杆菌(Helicobacter pylori,H.pylori)感染的相关性.方法 收集安徽医科大学第二附属医院2018年7月至2020年9月同时行肠镜及幽门螺旋杆菌血清学抗体检测的患者资料共460例,并分为结直肠息肉组、结直肠癌组、正常对照组,回顾性分析结直...     

Colorectal cancer in a population with endemic Schistosoma mansoni: is this an at-risk population?

Purpose Chronic infection with schistosomiasis has been clearly associated with the development of bladder cancer, and infestation is associated with a high incidence of colorectal cancer in endemic populations. Despite this association, the potential role of alterations in tumor suppressor genes colorectal cancers has never been evaluated in an endemically infected population. The aim of this paper was to compare histopathologic and genetic changes in schistosomal colitis-associated colorectal cancer (SCC) with colorectal cancer in a group of patients from the same population not affected by the disease (NDCC). Materials and methods Sixty patients were included in this study: SCC—40, NDCC—20. Data collected included age, sex, clinical presentation, presence of synchronous tumors, histopathology, and clinical stage. p53, DCC (deleted in colorectal cancer gene), and mismatch repair genes (MLH1 and MSH2) were studied using immunohistochemical staining. Results Patients with SCC were significantly younger than the NDCC group (34.52±11.22 years vs 50.73±12.75 years, p=0.02). Mucinous adenocarcinoma occurred significantly more frequently in SCC (35 vs 10%, p=0.02). SCC tumors were more frequently stage III or IV, and significantly more synchronous tumors were present in the affected group (SCC—8/40 vs NDCC—1/20, p=0.05). p53 staining was far more frequent in SCC (SCC—32/40 vs NDCC—8/20, p=0.006). DCC expression was similar in two groups. There were only four cases, three in SCC and one in NDCC, that showed microsatellite instability. Conclusion The data suggest that schistosomal colitis is more commonly associated with earlier onset of multicentric colorectal cancer, high percentage of mucinous adenocarcinoma, and presents at an advanced stage. The identification of a higher incidence of altered p53 expression in the SCC group raises the possibility of an association between schistosomiasis and alterations in p53 activation as an inciting event in colorectal cancer development.     

上海石化地区老年人血吸虫病相关性结直肠癌临床病理特征及预后分析

目的 探讨血吸虫病对老年人结直肠癌组织学分型、分化程度、浸润深度、淋巴结转移等恶性生物学行为以及预后的影响.方法 收集我院2004年1月至2010年12月间60岁及以上老年人结直肠癌根治标本184例,分为两组:血吸虫病相关结直肠癌(colorectal carcinoma with schistosomiasia,CRCS)组102例,单纯结直肠癌(colorectal carcinoma,CRC)组82例.以CRC组为对照,分析血吸虫病对老年人结直肠癌临床病理特征的影响.同时,收集2004年1月至2006年12月间40例老年人结直肠癌预后资料并进行相关分析.结果 184例老年人结直肠癌中55.4％(102/184)合并血吸虫病.与CRC组比较,老年人结直肠癌发生部位、生长方式、分化程度、浸润深度、淋巴结转移以及TNM分期与血吸虫病密切相关(x2值分别为16.53、10.81、10.46、6.71、3.90、5.73,均P＜0.05).生存分析发现血吸虫病对老年人结直肠癌患者生存时间影响不明显(x2=0.14,P＞0.05).结论 合并血吸虫病与老年人结直肠癌的恶性生物学行为有关,但对术后生存时间无显著影响.     

Bcl?2与Bax基因在结直肠癌合并血吸虫病患者体内表达及临床病理意义

目的　探讨Bcl?2和Bax基因在结直肠癌（CRC）合并血吸虫病患者体内的表达水平及其临床病理意义。方法　以2016年6月—2020年6月在大理大学第一附属医院接受手术治疗的CRC患者作为研究对象,采用随机数字表法从单纯CRC患者和CRC合并血吸虫病患者中各随机抽取30例作为CRC组和CRC?S组。收集两组患者癌组织和CRC组患者癌旁组织,采用实时荧光定量PCR法和免疫组织化学法检测样本中Bcl?2和Bax mRNA和蛋白表达水平,应用HE染色法观察并比较两组患者癌组织细胞凋亡率。结果　共纳入研究对象60例,其中CRC组和CRC?S组均30例,两组患者性别构成（[χ2] = 0.271,P＞0.05）、平均年龄（t = -0.596,P＞0.05）、结直肠肿瘤生长方式（[χ2] = 0.275,P＞0.05）、肿瘤部位（[χ2] = 4.008,P＞0.05）、肿瘤浸润深度（[χ2] = 0.608,P＞0.05）、肿瘤分化程度（[χ2] = 0.364,P＞0.05）及肿瘤是否脉管转移（[χ2] = 1.111,P＞0.05）差异均无统计学意义,但肿瘤组织学类型、肿瘤是否淋巴结转移和TMN分期差异均有统计学意义（[χ2] = 5.963、8.297、5.711,P均＜0.05）。与CRC组患者癌旁组织相比,CRC组和CRC?S组患者癌组织中Bcl?2、Bax mRNA和蛋白表达水平均升高（P均＜0.05）;与CRC组相比,CRC?S组患者癌组织中Bcl?2 mRNA和蛋白表达水平均升高（P均＜0.05）,Bax mRNA和蛋白水平均降低（P均＜0.05）。CRC组和CRC?S组患者肿瘤组织细胞凋亡率分别为42.00%和25.35%,差异有统计学意义（[χ2] = 41.500,P = 0.000）。结论　血吸虫病可能通过影响细胞凋亡信号通路中Bcl?2和Bax基因表达而参与CRC发生与进展。     

Relationship between Helicobacter pylori CagA status and colorectal cancer

OBJECTIVES: Infection with Helicobacter pylori, particularly with strains positive for CagA protein, increases the risk of gastric adenocarcinoma. Few studies have explored the possible association between H. pylori infection and colorectal cancer. This study evaluated whether the seroprevalence of CagA in H. pylori-infected patients affected risk for colorectal cancer independently of H. pylori status. METHODS: In this study, we tested serum IgG antibodies against H. pylori (ELISA) and CagA protein (Western blot assay) in 67 patients with colorectal adenocarcinoma, 36 with gastric adenocarcinoma, 47 with other malignancies (cancer controls), and 45 hospitalized for transesophageal echocardiography (TEE controls). Colonic cancer and gastric cancer patients with H. pylori infection were compared to each control group and to the pooled controls using simple and adjusted analyses. RESULTS: H. pylori infection was noted in 50 colon cancer patients, 31 gastric cancer patients, 31 cancer controls, and 32 TEE controls. In all, 41 (82%), 29 (94%), 11 (35%), and 13 (41%), respectively, of these H. pylori-positive sera expressed CagA reactivity (p < 0.001 for all pairwise comparisons between cases and controls). In the adjusted analysis, infection with H. pylori CagA+ compared to H. pylori CagA- was associated with increased risk for colorectal adenocarcinoma (odds ratio = 10.6; 95% CI = 2.7-41.3; p = 0.001) and gastric adenocarcinoma (odds ratio = 88.1; 95% CI = 6.3-1229.2; p = 0.001). CONCLUSIONS: Among patients infected with H. pylori, CagA+ seropositivity is associated with increased risk for both gastric and colonic cancer. This finding should stimulate additional research into the role of cagA+ H. pylori infection in the development of colorectal cancer.     

晚期血吸虫病肝纤维化患者血清维生素D水平与免疫失衡的关系

目的 探索晚期血吸虫病肝纤维化患者血清维生素D水平与免疫失衡间的关系.方法 选择2016年5月至2018年9月就诊于嘉兴市第一医院血吸虫病科的120例晚期血吸虫病肝纤维化患者作为观察组,选取50例同期该院健康体检者作为对照组,比较两组血清中IgG抗体、IgA抗体、C3补体、C4补体、CD4+细胞比例、CD8+细胞比例、...     

幽门螺杆菌相关性十二指肠球溃疡与胃癌中NF—KB、VEGF、Bcl-2、IL-1β的表达及意义

目的探讨Hpylori相关性十二指肠溃疡与胃癌病例中NF—KB、Bcl-2、VEGF、IL-1β表达的差异及相互关系，进一步了解Hpylori致胃癌与十二指肠溃疡的发病机制。方法选取胃镜检查的胃黏膜活检标本，十二指肠溃疡患者33例，胃癌患者63例，通过免疫组化sP法测定NF—KB、Bcl-2、VEGF、IL-1β在H．pylori感染与非感染的胃癌及十二指肠溃疡患者胃黏膜中的表达情况。结果十二指肠溃疡组和胃癌组中，H．pylori感染者NF—KB、VEGF与IL-1β的表达水平高于npylori阴性者（P〈0．Ol或0．05），Bcl-2的表达无显著差异（P〉0．05）；H．pylori感染病例中，NF—KB、Bcl-2、VEGF在胃癌组的表达水平高于十二指肠溃疡组（P〈0．01或0．05），IL-1β的表达无显著差异（P〉0．05）；胃癌组与球溃疡组中，NF—KB的表达水平与VEGF均呈正相关（P〈0．05）；胃癌组巾，NF—KB和VEGF的表达水平与Bcl-2呈正相关（P〈0．05），与IL-1β表达水平无明显相关性（P〉0．05）；球溃疡组中，NF—KB和VEGF的表达水平与IL-1β表达水平呈正相关（P〈0．05），与Bcl-2表达水平无明显相关性（P〉0．05）．结论幽门螺杆菌感染可上调宿主胃黏膜上皮NF—KB、VEGF及IL-1β的表达，三者表达水平具有协同性，其中NF—KB、VEGF表达的差异与十二指肠溃疡与胃癌两种不同的疾病转归相关，     

Gastric dysplasia may be an independent risk factor of an advanced colorectal neoplasm

AIM: To evaluate the relationship between gastric dysplasia and Helicobacter pylori ( H pylori) and the occurrence of colorectal adenoma, and to define the necessity for colonoscopy in patients with gastric dysplasia or H pylori infection.METHODS: From May 2005 to February 2008, 133 patients with established gastric dysplasia by gastroduodenoscopy (EGD) were additionally investigated by colonoscopy. The authors compared results with those of 213 subjects who underwent both EGD and colonoscopy during the same period at the author's Health Promotion Center as a control group. H pylori infection was evaluated in both the gastric dysplasia and control groups.RESULTS: The mean age of all 346 study subjects was 54.1 ± 10.5 years, and there were 258 (73%) men and 87 (27%) women. No significant difference was found between the H pylori positive and negative subjects in terms of the prevalence of colorectal adenoma and advanced colorectal adenoma ( P = 0.261). Patients with gastric dysplasia showed no elevated risk of colorectal adenoma (OR = 0.910, 95% CI: 0.5871.411,P = 0.738),but had a significantly higher risk of having advanced colorectal adenoma (OR = 3.382, 95% CI: 1.7006.342,P = 0.000).CONCLUSION: The study emphasizes the need for colon surveillance in patients with gastric dysplasia,regardless of H pylori infection.