幽门螺旋杆菌相关性胃病与HP基因分型的关系研究

Study on the Relationship between Helicobacter pylori Associated Gastropathy and HP Genotyping in Qinghai Province

摘要: 目的：通过检测青海地区慢性非萎缩性胃炎(CSG)、慢性萎缩性胃炎(CAG)及胃腺癌(GC)等患者胃粘膜组织中的幽门螺旋杆菌(H. pylori)菌株的基因分型，探讨各基因型与三组疾病之间的关系。方法：收集2019年12月至2020年12月在青海大学附属医院就诊的满足排标准的，并经13C或14C尿素呼气试验检测证实存在H. pylori感染的并行胃镜及病理组织学检查诊断为CAG、CAG、GC的患者共78例为研究对象，通过胃镜活检提取胃粘膜组织并分离培养获得H. pylori菌株，将上述获得的H. pylori菌株提取DNA，采用PCR扩增方法检测上述样本中的CagA、VacA (s1、s2、m1、m2)、UreA、UreB，babA等基因型分布。结果：1) 本实验共扩增出78例H. pylori菌株，其中CSG组24例，CAG组36例，GC组18例。CagA基因共检测出72例，总体检出率为92.31% (P > 0.05)。BabA、UreA、UreB基因检出率分别为64.1%、64.10%、79.49% (P > 0.05)。VacA基因亚型VacAs1、VacA s2、VacA m1、VacA m2基因检出率分别为75.64%、15.38%、42.31%、53.85% (P > 0.05)。2) H. pylori各基因型在三组疾病间的分布无显著统计学差异(P > 0.05)。结论：1) 青海地区H. pylori感染人群中CagA、VacA及尿素酶基因是本地检出率最高的基因型；2) H. pylori各基因型不能作为判断慢性胃炎是否能发展成胃癌及癌前病变的特异性标志。

Abstract: Objective: To study the genotypes of H. pylori strains in the gastric mucosa of patients with chronic non-atrophic gastritis (CSG), chronic atrophic gastritis (CAG) and gastric adenocarcinoma (GC) in Qinghai, and to explore the relationship between each genotype and the three groups of diseases. Methods: Collected patients who met the exclusion criteria in the Affiliated Hospital of Qinghai University from December 2019 to December 2020 were diagnosed with Helicobacter pylori infection by gastroscopy and histopathological examination through 13C or 14C urea breath test. A total of 78 patients with CAG, CAG, and GC were the subjects of this study. Gastric mucosal tissues were extracted by gastroscopy and cultured to obtain H. pylori strains. DNA was extracted from the H. pylori strains obtained above. Genes such as CagA, VacA (s1, s2, m1, m2), UreA, UreB, BabA were detected by PCR and sequencing. Results: 1) A total of 78 H. pylori strains were amplified in this experiment, including 24 cases in CSG group, 36 cases in CAG group and 18 cases in GC group. A total of 72 cases of CagA gene were detected, and the overall detection rate was 92.31% (P > 0.05). The positive rates of BabA, UreB and UreB genes were 64.1%, 64.10% and 79.49% (P > 0.05), respectively. The positive rates of VacAs1, VacA s2, VacA m1 and VacA m2 subtypes were 75.64%, 15.38%, 42.31% and 53.85% (P > 0.05), respectively. There was no significant statistical difference in the distribution of H. pylori genotypes among the three groups (P > 0.05). Conclusion: 1) CagA, VacA and urease genes were the genotypes with the highest local detection rate in H. pylori infected people in Qinghai. 2) H. pylori genotypes could not be used as a specific marker to determine whether chronic gastritis could develop into gastric cancer and precancerous lesions.