幽门螺杆菌毒力基因cagA、cacA与胃十二指肠疾病的关系

国际上已有很多国家对本国幽门螺杆菌 (Ｈｅｌｉ ｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ)分离株的ｖａｃＡ基因进行了研究和分析。Ａｔｈｅｒｔｏｎ等曾提出ＨｐｖａｃＡ基因镶嵌型模型 ,将信号序列分为三型 ,中间序列分为两型〔1〕 ,但来自欧洲和日本的报告显示不同地区Ｈｐ分离株具有较高多态性 ,具有地区、人群相关性特点。然而 ,目前国内尚未见这方面的研究报告。为了解我国Ｈｐ临床分离株ｖａｃＡ基因型特点以及不同ｖａｃＡ基因同胃、十二指肠疾病的关系以及ｃａｇＡ基因同Ｈｐ毒力的关系 ,本实验进行了以下研究。材料与方法菌株 :113株…     

幽门螺杆菌感染与慢性胃炎及消化性溃疡的临床分析

目的：分析幽门螺杆菌(Hp)感染与慢性胃炎及消化性溃疡的相关性。方法资料随机选取2013年2月~2014年2月本院经胃镜检查病诊断的124例慢性胃炎及消化性溃疡患者作为研究组,并选取同期行健康检查并行胃镜检查的健康体检者104例作为对照组,两组患者予以胃粘膜组织活检,并分析幽门螺杆菌与炎性反应情况。结果研究组患者的幽门螺杆菌检出率62.90%明显高于对照组25.96%,比较差异具有统计学意义(P<0.05);研究组患者慢性胃炎及消化性溃疡患者的Hp阳性检出率比较差异不明显,无统计学意义(P>0.05),且消化性溃疡患者中活动期Hp阳性率明显高于非活动期,比较差异具有统计学意义(P<0.05)。结论幽门螺杆菌(Hp)感染与慢性胃炎及消化性溃疡的关系密切,临床实际检查诊断中可作为可靠依据,有效提高患者的临床诊断率。     

CagA和机体免疫反应在幽门螺杆菌致病中的作用及相互关系

目的　探讨幽门螺杆菌 (Helicobacterpylori,Hp)菌型差异和机体免疫反应在Hp致病中的作用及其相互关系。方法　采用间接ELISA法检测了 175例患者血清抗HpCagA IgG和抗HpIgE。结果　①Hp感染者抗HpCagA IgG的阳性率 (80 % )明显高于抗HpIgE(5 8 2 9% ,P <0 0 1)。②血清抗HpCagA IgG在慢性活动性胃炎 (ACG)和十二指肠球部溃疡 (DU)患者显著高于胃溃疡 (GU)、胃癌(GCa)、慢性非活动性胃炎 (NACG)和对照组 (P <0 0 1) ,而后 4组之间差异无显著性。③血清抗HpIgE在ACG显著高于DU、GU、GCa、NACG和对照组 (P <0 0 1) ,并且在中重度胃炎显著高于轻度胃炎(P <0 0 0 1)。④血清抗HpCagA IgG和抗HpIgE无明显相关性 (r=0 2 45 9,P >0 0 5 )。结论　CagA和血清抗HpIgE参与了Hp的致病过程 ,但是两者之间无明显相关性 ,并且它们在疾病中的含量也有一定差异 ,这说明二者在Hp的致病过程中是相互独立的因素 ,Hp感染引起疾病是多因素的综合作用。     

康胃散治疗幽门螺杆菌相关性慢性胃炎及消化性溃疡临床疗效观察

目的研究康胃散治疗幽门螺杆菌（Hp）相关性慢性胃炎及消化性溃疡的临床疗效。方法搜集在我院进行治疗的162例幽门螺杆菌相关性慢性胃炎及消化性溃疡病例,分为观察组81例和对照组81例,观察组采用康胃散治疗,对照组采用普通消炎药进行治疗。观察两组临床疗效,主要包括幽门螺杆菌消灭率、溃疡愈合情况等。结果观察组的幽门螺杆菌消灭率达到91%,胃溃疡愈合率达到94.8%。对照组的幽门螺杆菌消灭率为90%,胃溃疡愈合率达92.4%。结论康胃散对治疗幽门螺杆菌相关性慢性胃炎及消化性溃疡有显著疗效,值得在临床中推广。     

机体免疫反应和CagA对幽门螺杆菌长期感染转归的影响

10年前在我院行胃镜、病理和Ｈｐ检测确诊为Ｈｐ阳性者 6 3例 ,10年后到我院复查再次行上述检查 ,其中 16例转阴 ,47例仍为阳性。采用细菌培养和Ｇｉｅｍｓａ染色检测胃粘膜内Ｈｐ ,用间接ＥＬＩＳＡ法检测了 47例Ｈｐ持续感染 10年患者血清抗ＨｐＣａｇＡ ＩｇＧ和抗ＨｐＩｇＥ ,并检测了这些患者 10年前后胃镜和病理组织学变化。47例Ｈｐ持续阳性患者 10年前后消化性溃疡 (ＰＵ)的发生率由 14例(2 9 78% )发展至 2 5例 (5 3 19% ) (Ｐ <0 .0 5 ) ;胃粘膜糜烂由 8例 (17 0 2 % )发展至 18例 (38 2 9% ) (Ｐ <0 .0 5 ) ;肠上皮化生 (ＩＭ)由…     

幽门螺杆菌与十二指肠疾病及胃上皮化生的关系

研究幽门螺杆菌与十二指肠疾病及其胃上皮化生的关系。方法：应用特殊染色方法对１６６例胃窦及十二指肠活检标本进行了形态学观察及ＨＰ检测。     

TNF基因多态性与胃十二指肠疾病幽门螺杆菌感染的相关性研究

目的：研究我国湖北汉族人群肿瘤坏死因子（Tumor Necrosis Factor,TNF）基因多态性与胃十二指肠疾病及幽门螺杆菌（Helicobacter Pylori,Hp）感染的关系,探讨宿主遗传因素对Hp感染在胃十二指肠疾病尤其是非贲门胃癌的作用.方法：采用病例对照研究和PCR-RFLP方法,检测210例胃十二指肠疾病患者（包括73例慢性胃炎、78例十二指肠溃疡及59例非贲门胃癌患者）和264例正常对照者的TNF-α 308、LT-α Nco Ⅰ、AspH Ⅰ双等位基因型分布.Hp感染检测血清Hp Ab-IgG.结果：胃十二指肠疾病患者的Hp阳性率90.5%,显著高于正常对照组62.1%（P＜0.000 1,Odds ratio=5.793,95%CI：3.431～9.780）.LT-α Nco Ⅰ A/G基因型在Hp阳性非贲门胃癌患者（64.0%）高于Hp阳性的正常对照组（46.0%）,差异有显著性意义（P=0.029 7,OR=2.026,95%CI：1.080～3.803）,该基因型与其他胃十二指肠疾病无相关性.TNF-α 308、LT-α AspH Ⅰ与Hp感染及胃十二指肠疾病亦无相关性.结论：LT-α Nco Ⅰ A/G基因型与中国湖北汉族人群非贲门胃癌Hp阳性相关.     

CagA和机体免疫反应在幽门螺杆菌致病中的作用及 …

目的 探讨幽门螺杆菌（Ｈｅｌｉｃｂａｃｔｅｒ ｐｙｌｏｒｉ,Ｈｐ）菌型差异和机体免疫反应在Ｈｐ致病听作用及其相互关系。方法 采用间接ＥＬＩＳＡ法检测了１７５例血清抗Ｈｐ ＣａｇＡ－ＩｇＧ和抗Ｈｐ ＩｇＥ。结果 ①Ｈｐ感染者抗Ｈｐ ＣａｇＡ－ＩｇＧ的阳性率（８０％）明显高于抗Ｈｐ ＩｇＥ（５８．２９％,Ｐ〈０．０１）。②血清抗Ｈｐ ＣａｇＡ－ＩｇＧ在慢性活动性胃炎（ＡＣＧ）和十二指肠球部溃疡（ＤＵ）     

Assessment of different methods for staining Helicobacter pylori in endoscopic gastric biopsies

The recent implication of Helicobacter pylori in the pathogenesis of gastritis-peptic ulcer syndrome and its relevance for the development of upper gastrointestinal malignancy warrant efficient methods for the detection and demonstration of the organism in biopsy specimens. We have compared 5 staining methods, namely, haematoxylin and eosin (H & E), immunohistochemistry (IHC), the silver staining HpSS, the alcian yellow-toluidine blue (Leung) method (A-Y) and Genta staining, for the demonstration of the organism in gastric biopsies taken from antrum, body and fundus of 118 patients who presented to our hospital with upper gastrointestinal symptoms. We found no significant differences in the efficacy of H & E, IHC, HpSS and A-Y in the demonstration of H. pylori in all 3 gastric sites. The least reproducible stain in our hands was the Genta stain. We conclude that H & E is adequate for the initial assessment of gastric biopsies in symptomatic upper gastrointestinal patients. This is because it is a well-tested, cheap and easy staining method, requiring a relatively short period of time to perform, with highly reproducible results. It has an added advantage of enabling simultaneous assessment of morphological changes accompanying H. pylori infection. When the density of the organism is expected to be low, we recommend addition of HpSS staining because of its high sensitivity and low cost. The disadvantages of the other staining methods (IHC, A-Y and Genta) are discussed.     

Transforming growth factor alpha and epidermal growth factor in human pancreatic cancer.

Overexpression of the epidermal growth factor receptor (EGFR) has been reported as an important molecular abnormality in human pancreatic cancer. There is in vitro evidence that simultaneous overproduction of one of its ligands, transforming growth factor alpha (TGF-alpha), might result in an autocrine loop with an increased proliferation signal. We analysed by immunocytochemical staining a retrospective series of human pancreatic cancers, chronic pancreatitis, and normal fetal and adult pancreatic tissues for the presence of TGF-alpha and epidermal growth factor (EGF). Ductal epithelial cells showed TGF-alpha immunoreactivity in both normal tissue and chronic pancreatitis, and 95 per cent of tumours showed strong immunoreactivity. In contrast, EGF immunoreactivity was not found in normal pancreas, but was expressed in 12 per cent of pancreatic carcinomas. Well-defined areas of EGF immunoreactivity in exocrine ducts showing reactive changes in pancreatitis might represent a benign response to tissue damage similar to that previously described in the gastric mucosa.     

Modes of adherence of Helicobacter pylori to gastric surface epithelium in gastroduodenal disease: a possible sequence of events leading to internalisation

We have investigated various modes of adherence of Helicobacter pylori to the human gastric epithelium, using transmission electron microscopy, in biopsies from nine patients with peptic ulcer disease and from four patients with chronic active gastritis. H. pylori was demonstrated in abundance in all cases within the surface mucous layer. In all ulcer- and in one out of four gastritis patients H. pylori was shown in close proximity to the gastric epithelium, with concurrent alterations in the configuration of microvilli and the apical cytoplasmic region of gastric cells. Previously described modes of H. pylori adherence were confirmed, such as loose attachment with fibrillar-like strands, firm attachment with pedestal formation, invasion in the intercellular spaces, and invagination with "cup" formation. Moreover, in many cases a fusion between the bacterial outer layer and gastric cell membranes was evident. In four cases (31%; three with active and one with past ulcer disease) viable H. pylori was found in the cytoplasm of gastric mucous cells. Our results support the hypothesis that the different modes of adherence of H. pylori represent a stepwise, possibly sequential, process which in a significant number of cases leads to internalisation of the organism. The invariable occurrence of adhesion and more frequent internalisation of H. pylori in ulcer patients may suggest a link with the pathogenesis of peptic ulcer disease.     

Effect of Helicobacter pylori infection on epidermal growth factor receptor (EGFR) expression and cell proliferation of gastric epithelial mucosa: correlation to macroscopic and microscopic diagnosis

Our aim was to compare the expression of EGFR and proliferative cell nuclear antigen (PCNA) in different histological and endoscopic diagnostic groups, in cases of Helicobacter pylori infection, in vivo. Paraffin embedded human gastric biopsy samples (86) were analysed by EGFR and PCNA immunohistochemistry and classified both on the basis of histology and endoscopic findings. In normal epithelia (NE), a positive correlation was found between PCNA and EGFR and in H. pylori-negative gastritis with and without intestinal metaplasia (P < 0.01). On the other hand, a negative correlation was detected between the two immunohistochemical findings in H. pylori-associated gastritis with intestinal metaplasia (HPGIM) and in the atrophic gastritis (AG) group. In HPGIM the percentage of EGFR-positive cells was significantly lower (32.4 +/- 30.4) when compared to either the NE (50.3 +/- 23.7) or H. pylori-negative gastritis with intestinal metaplasia (HNGIM) (48.3 +/- 23.7). In AG, EGFR was significantly lower when compared to the NE (P < 0.05). Based on the endoscopic findings, a significant decrease of EGFR expression was found in gastric ulcer cases as compared to NE, gastritis or erosion cases (P < 0.01). PCNA showed no significant alterations between the NE and gastritis, AG groups. The presence of H. pylori has an inverse effect on PCNA and EGFR expression in HPGIM.     

溃疡病患者胃肠运动功能障碍及表皮生长因子的变化

用连续灌注导管测压，并测定胃液和血清的表皮生长因子（ＥＧＦ）的含量，为了解十二指肠球溃疡（ＤＵ）患者消化间期移行性复合运动（ＭＭＣ）的规律，及其胃液和血清中的表皮生长因子含量的变化。结果显示：１、６０％ＤＵ患者缺乏ＭＭＣⅢ期，与正常人比Ｐ＜０．０５。２、ＤＵ患者ＭＭＣⅢ期持续时间（２．９±１．９ｍｉｎ）比正常人（４．３±１．１ｍｉｎ）缩短，（Ｐ＜０．０５）。３、ＤＵ患者ＭＭＣⅢ用十二指肠近端及远端的运动波幅较正常人减低（Ｐ＜０．０１）。４、ＤＵ患者的胃液和血清的表皮生长因子含量显著降低，分别为１９９．２７±１４７．８１ｐｇ／ｍＬ和１４８．６７±１２４．３１ｐｇ／ｍＬ，（Ｐ＜０．０１）。说明消化间期移行性复合运动和表皮生长因子在十二指肠球溃疡发病机理上起一定作用。     

表皮生长因子受体与胃癌的研究进展

胃癌的发生与发展机制十分复杂,涉及多种细胞病理改变。表皮生长因子受体(epidermal growth factor receptor,EGFR)及其参与的信号转导通路在胃癌的发生发展中起着重要的作用。近年来,发现多数肿瘤对放化疗存在的耐药性,因此在肿瘤的基因水平寻找诊断指标以及靶向治疗,已经成为近年来研究热点之一。本文综述表皮生长因子与胃癌的研究进展。     

Gene expression and immunolocalization of heparin-binding epidermal growth factor-like growth factor and human epidermal growth factor receptors in human corpus luteum

BACKGROUND: The objective of this study was to elucidate gene expression and immunolocalization of heparin-binding epidermal growth factor-like growth factor (HB-EGF) and human epidermal growth factor receptor (HER) family in the human ovary during luteal growth and regression. METHODS: Ovaries obtained from pre-menopausal women were used for immunohistochemistry and semiquantitative RT-PCR analysis. RESULTS: Immunoreactive HB-EGF was not detected in follicles or oocyte, while HB-EGF became apparent in granulosa luteal cells in the early luteal phase, and most abundant in the mid-luteal phase, but less abundant in the late luteal phase. Immunostaining for HER1 was very weak in granulosa luteal cells in the early and mid-luteal phases, and was not detected in the late luteal phase. Immunoreactive HER4 was abundant in the early luteal phase and became less abundant in the mid-luteal phase, whereas it was negative in the late luteal phase. Semiquantitative RT-PCR analysis revealed that HB-EGF and HER1 mRNA levels were high in the mid-luteal phase, whereas HER4 mRNA expression was high in the early luteal phase. CONCLUSIONS: HB-EGF may play a vital role in regulating luteal growth in a juxtacrine manner and through activating HER4 signalling.     

Immunohistochemical investigation of epidermal growth factor receptor expression in ameloblastomas

Immunohistochemical analysis was performed to determine the localization of epidermal growth factor receptor (EGFR) in ameloblastomas. Ameloblastoma samples were classified into follicular, plexiform, and basal cell types. The number of cases in each category was 17, 19 and 3, respectively. Ameloblastomas, disregarding their histological type, consist of two cell forms: peripheral columnar cells and central stellate cells. The frequency of EGFR expression was much higher in the latter than in the former (P<0.005). On analysis with respect to histological types, the frequency of EGFR expression in columnar cells was not significantly different between the follicular and the plexiform types, but was observed more frequently in the stellate cells in the follicular than in the plexiform ameloblastomas (P<0.05). This pattern of EGFR expression was not consistent with the PCNA staining pattern, but was similar to that of keratin expression which we have reported previously. The present study suggests that EGFR expression in ameloblastomas is closely associated with tumour differentiation, and squamous differentiation in particular.     

鼻咽癌中表皮生长因子受体与相关信号蛋白关系及对细胞增殖的影响

目的 研究表皮生长因子受体(EGFR)与细胞增殖相关信号分子p-ERK、c-fos、Ki-67在鼻明癌及鼻咽黏膜上皮中表达的关系及其抑制剂西妥昔(Cetuximab)对鼻咽癌CNE-2Z细胞增殖的影响.方法 用链霉菌抗生物索蛋白-过氧化物酶(SP)法检测30例鼻咽癌(男性22例,女性8例;年龄28～70岁,中位年龄49...