标题：新疆维吾尔族人群幽门螺旋杆菌毒力CagA和VacA表达与胃癌的相关性

      作者：阿依努尔·阿合曼 1，美丽克扎提·安扎尔 1，李扎·居马 2    (1.新疆维吾尔自治区人民医院消化内科，新疆 乌鲁木齐 830001；2.乌鲁木齐市新市区三公社区服务中心，新疆 乌鲁木齐 830000)

      卷次： 2017年28卷19期

      【摘要】 目的 探讨新疆维吾尔族人群幽门螺旋杆菌(H. pylori，Hp)毒力CagA和VacA表达与胃癌的相关性。方法 采用病例-对照研究方法选取2014年1月至2016年11月新疆维吾尔自治区人民医院病理学确诊的新疆维吾尔族人群胃癌患者98例为病例组，同期确诊为非肿瘤性胃病的维吾尔族患者298例为对照组。采用免疫印迹法检测两组患者血清Hp抗体水平及其毒力CagA和VacA表达情况。同时比较两组患者的年龄、性别、体质量指数(BMI)、吸烟史、饮酒史、肿瘤家史等。将有统计学意义的因素及Hp CagA和VacA表达进一步带入Logistic回归方程，筛选维吾尔族人群胃癌的高危因素，并探讨Hp毒力CagA和VacA表达与胃癌相关性。结果 病例组患者Hp血清学阳性率为76.5%，对照组阳性率为72.1%，两组比较差异无统计学意义(P>0.05)；对照组患者中十二指肠溃疡组、胃溃疡组和浅表性胃炎组的Hp血清学阳性率分别为82.7%，85.1%和58.3%，浅表性胃炎组明显低于胃溃疡组和十二指肠溃疡组，差异均有统计学意义(P<0.05)；病例组患者的CagA+、VacA+及CagA+与VacA+全阳性率分别为81.3%、84.0%和81.3%，明显高于对照组的62.8%、61.9%和61.9%，且差异均有统计学意义(P<0.05)；单因素分析显示，病例组与对照组在吸烟史、饮酒史、肿瘤家族史、常食用腌制食物和CagA+ VacA+全阳性表达方面比较差异均有统计学意义(P<0.05)；Logistic回归分析显示，肿瘤家族史(OR=3.21，95%CI：1.69~5.22，P<0.05)和CagA+VacA+全阳性表达(OR=2.12，95%CI：1.23~4.21, P<0.05)为胃癌的独立危险因素。结论 新疆维吾尔族胃癌患者Hp感染率较高，CagA+ VacA+全阳性表达可能是胃癌的独立危险因素。
      【关键词】 新疆；维吾尔族；幽门螺旋杆菌；毒力；胃癌；危险因素
      【中图分类号】 R735.2 【文献标识码】 A 【文章编号】 1003—6350（2017）19—3106—04

Correlation of the expression of Helicobacter pylori CagA and VacA with gastric cancer risk in Xinjiang Uygurpopulation.
Ayinuer·aheman 1, Meilikezati·Anzaer 1, Lizha·juma 2. 1. Department of Gastroenterology, People's Hospital ofXinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang, CHINA; 2. New Urban District Three Community ServiceCenter of Urumqi, Urumqi 830000, Xinjiang, CHINA
【Abstract】 Objective To explore the correlation of the expression of Helicobacter pylori CagA and VacA withgastric cancer risk in Xinjiang Uygur population. Methods This is a case-control study which recruited 98 cases of gas-tric cancer (the disease group) and 298 cases of non-cancer gastric diseases (the control group) from Jan. 2014 to Nov.2016 in People's Hospital of Xinjiang Uygur Autonomous Region. The serum CagA and VacA antibody in H. pylori (Hp)were tested by Western blotting. The clinical characteristics such as age, gender, BMI, smoking history, alcohol historycarcinoma history of the two groups were recorded and compared. Logistic regression was used to select the independentrisk factors for gastric cancer. And further evaluate the association of the expression of CagA and VacA with gastric can-cer risk. Results The serum Hp positive rate were 76.5% in disease group versus 72.1% in the control group (P>0.05).However, the serum Hp positive rate of the duodenal ulcer group, gastric ulcer group and superficial gastritis group inthe desease group were 82.7%, 85.1%, 58.3%, respectively, and the superficial gastritis group was significant lower thanthat of the duodenal ulcer and gastric ulcer group (P<0.05). The positive rate of CagA+, VacA+ and both CagA+ and Va-cA+ were 81.3%, 84.0%, 81.3%, respectively in the disease group versus 62.8%, 61.9%, 61.9% in the control group (P<0.05). Single factor analysis indicated that there were significant differences between the two groups in smoking history,alcohol history, often eating pickled food, tumor history and the positive expression of CagA+ and VacA+ (P<0.05). Lo-gistic regression analysis showed tumor history (OR=3.21, 95% CI: 1.69-5.22, P<0.05) and the both positive expressionof CagA+ and VacA+ (OR=2.12, 95% CI: 1.23-4.21, P<0.05) were independent risk factors for gastric cancer in Xinji-ang Uygur population. Conclusion Hp infection rate is higher in patients with gastric cancer in in Xinjiang Uygur pop-ulation, and the positive expression of CagA+ and VacA+ may be an independent risk factor of gastric cancer.
      【Key words】 Xinjiang; Uygur population; Helicobacter pylori (Hp); Virulence; Gastric cancer; Risk factors