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目的 探讨幽门螺杆菌 (Hp)感染对胃黏膜端粒酶活性的影响及与胃癌的相关性。 方法 用端粒酶重复序列扩增法 (TRAP)检测 6 6例胃癌、30例萎缩性胃炎及 2 0例正常胃黏膜标本端粒酶活性 ,以尿素酶法及病理组织学方法检测Hp感染。 结果 端粒酶活性检出率及Hp感染率分别为 :正常胃黏膜 1 0 % (2 / 2 0 )、35 % (7/ 2 0 ) ;萎缩性胃炎 36 .6 % (1 1 / 30 )、4 3.3% (1 3/ 30 ) ;胃癌 89.5 % (5 9/ 6 6 )、6 6 .6 % (4 4 / 6 6 )。被检标本的二者检出率随病变加重而增高。Hp感染标本的端粒酶活性检出率比无Hp感染者高。三组资料χ2 检验优势比 ,胃癌组OR值 =6 ,提示Hp阳性者的危险性是Hp阴性者的 6倍 ,有显著性差异。但不论有无Hp感染 ,其端粒酶检出率均随病变程度加重而增加。正常胃黏膜标本中有端粒酶活性检出的标本均有Hp感染 ,而从胃炎及胃癌标本中检出的端粒酶阳性标本有 6 0 %以上有Hp感染。 结论 端粒酶活性检测可作为胃癌诊断的参考指标 ;Hp感染可激活端粒酶 ,加速胃黏膜损伤 ,引起一系列的病理改变可能与胃癌发生有关
Objective To investigate the effect of Helicobacter pylori (Hp) infection on telomerase activity in gastric mucosa and its correlation with gastric cancer. Methods The telomerase activity of 66 cases of gastric cancer, 30 cases of atrophic gastritis and 20 cases of normal gastric mucosa were detected by telomeric repeat amplification (TRAP). Hp infection was detected by urease and histopathology. Results The positive rates of detection of telomerase activity and Hp infection were 10% (2/20) and 35% (7/20) in normal gastric mucosa, 36.6% (11/30) in atrophic gastritis, , 43.3% (13/30), 89.5% (49/6 6), 66.6% (44/6 6) respectively. The detection rate of the two specimens increased with the disease increased. The detection rate of telomerase activity in Hp infected specimens was higher than that in Hp-infected individuals. Three sets of data χ2 test odds ratio, OR = 6 gastric cancer group, suggesting that the risk of Hp-positive Hp-negative 6 times, a significant difference. But with or without Hp infection, the detection rate of telomerase increased with the severity of the lesion. Hp infection was detected in specimens of normal gastric mucosa with telomerase activity, while Hp infection was detected in more than 60% of telomerase positive specimens from gastritis and gastric cancer specimens. Conclusion The detection of telomerase activity can be used as a reference indicator for the diagnosis of gastric cancer. Hp infection can activate telomerase, accelerate gastric mucosal injury and cause a series of pathological changes that may be related to the occurrence of gastric cancer