河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (12): 1442-1447.doi: 10.3969/j.issn.1007-3205.2023.12.013

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胃液总胆汁酸和幽门螺旋杆菌感染与胃癌的相关性研究

  

  1. 1.河北省石家庄市人民医院消化一科，河北 石家庄 050000；2.河北省石家庄市人民医院消化五科，河北 石家庄 050000；3.河北省石家庄市人民医院消化二科，河北 石家庄 050000

  • 出版日期:2024-01-02 发布日期:2024-01-02
  • 作者简介:牛晓蕾（1987-），女，河北石家庄人，河北省石家庄市人民医院主治医师，医学硕士，从事消化内科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究课题计划（20210923）

Study on the correlation between total bile acid in gastric juice, Helicobacter pylori infection and gastric cancer

  1. 1.The First Department of Gastroenterology, Shijiazhuang People′s Hospital, Hebei Province, 
    Shijiazhuang 050000, China; 2.The Fifth Department of Gastroenterology, Shijiazhuang People′s 
    Hospital, Hebei Province, Shijiazhuang 050000, China; 3.The Second Department of 
    Gastroenterology, Shijiazhuang People′s Hospital, Hebei Province, 
    Shijiazhuang 050000, China

  • Online:2024-01-02 Published:2024-01-02

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摘要： 目的 探讨胃液总胆汁酸（total bile acid，TBA）和幽门螺旋杆菌（Helicobacter pylori，Hp）感染与胃癌的关系。
方法 选择胃镜下诊断为胃癌的患者60例为研究组，病理检查诊断为腺癌；选择同期健康体检人群胃镜提示慢性非萎缩性胃炎患者60例为对照组，病理提示无腺体萎缩、异型增生、肠化生。抽取患者的胃液标准检测TBA浓度，对组织标本行免疫组化染色检测尾型同源盒2（caudal type homeobox 2,CDX2）、黏蛋白2（mucin 2,MUC2）、黏蛋白5AC（mucin 5AC,MUC5AC）的表达，采用快速尿素酶试验和组织学改良Giemsa染色检测Hp。
结果 研究组的TBA浓度高于对照组，Hp阳性感染率高于对照组（P＜0.05）。研究组CDX2阳性表达32例，占比53.33%，MUC2阳性表达33例，占比55.00%，MUC5AC阳性表达25例，占比41.67%；对照组CDX2、MUC2均无阳性表达，MUC5AC阳性表达52例，占比86.67%。研究组的CDX2和MUC2的阳性表达率高于对照组，MUC5AC阳性表达率低于对照组（P＜0.05）。研究组Hp阳性者的CDX2和MUC2的阳性表达率高于Hp阴性者，MUC5AC阳性表达率低于Hp阴性者（P＜0.05）。Hp阳性和胃液TBA浓度≥300 μmol/L是CDX2、MUC2阳性表达的危险因素（P＜0.05），是MUC5AC阳性表达的保护因素（P＜0.05）。
结论 胃液TBA浓度≥300 μmol/L和Hp阳性是CDX2、MUC2阳性表达的危险因素，是MUC5AC阳性表达的保护因素。胃液TBA和Hp可能通过影响CDX2、MUC2、MUC5AC的表达而影响胃癌的发生。


关键词: 胃肿瘤, 胆酸类, 幽门螺旋杆菌感染

Abstract: Objective To investigate the relationship of total bile acid (TBA) in gastric juice and helicobacter pylori (Hp) infection with gastric cancer. 
Methods Sixty patients diagnosed with gastric cancer under gastroscopy were selected as the research group. Adenocarcinoma was diagnosed by pathological examination. During the same period, 60 people for physical examination and with chronic non-atrophic gastritis (CNG) indicated by gastroscope were selected as the control group. Pathology showed no gland atrophy, dysplasia, or intestinal metaplasia. Gastric juice was extracted from the patients to detect the concentration of TBA, the expression of caudal type homeobox 2 (CDX2), mucin 2 (MUC2) and mucin 5AC (MUC5AC) in the tissue specimens were detected by immunohistochemical staining, and rapid urease test and histological modified Giemsa staining were used to detect Hp. 
Results The TBA concentration in the research group was higher than that in the control group, and the Hp positive infection rate was higher than that in the control group (P＜0.05). There were 32 patients with CDX2 positive expression in the research group, accounting for 53.33%, 33 patients with MUC2 positive expression, accounting for 55.00%, and 25 patients with MUC5AC positive expression, accounting for 41.67%. There was no positive expression of CDX2 and MUC2 in the control group, while MUC5AC was positive in 52 cases, accounting for 86.67%. The positive expression rates of CDX2 and MUC2 in the research group were higher than those in the control group, while the positive expression rate of MUC5AC was lower than that in the control group (P＜0.05). The positive expression rates of CDX2 and MUC2 in the Hp positive group were higher than those in the Hp negative group, while the positive expression rate of MUC5AC was lower than that in the Hp negative group (P＜0.05). Positive Hp and gastric TBA concentration ≥ 300 μmol/L were risk factors for CDX2 and MUC2 positive expression (P＜0.05), and protective factors for MUC5AC positive expression (P＜0.05). 
Conclusion TBA concentration in gastric fluid ≥ 300 μmol/L and Hp positivity are risk factors for CDX2 and MUC2 positive expression, and are protective factors for MUC5AC positive expression. TBA in gastric fluid and Hp may affect the occurrence of gastric cancer by affecting the expression of CDX2, MUC2, and MUC5AC. 


Key words: stomach neoplasms, cholic acids, Helicobacter pylori infection

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