重庆地区幽门螺杆菌的EPIYA基序多态性与胃十二指肠疾病的关系

发布时间：2018-09-06 13:42

【摘要】：目的:幽门螺杆菌(Helicobacter pylori,H.pylori)产生的细胞毒素相关蛋白A(cytotoxin associated antigen A,Cag A)羧基末端的EPIYA序列与胃十二指肠疾病的关系一直存在争议。本研究采集大量H.pylori高感染率同时也是胃癌高发病率的中国重庆地区的病例,通过检测患者感染的H.pylori Cag A羧基末端EPIYA基序的多态性,探讨EPIYA基序与临床胃十二指肠疾病发生的潜在关系。方法:收集消化不良患者的胃黏膜标本分离培养H.pylori,提取细菌基因组DNA,PCR扩增Cag A基因的3'端区域并分型,根据分型结果随机抽样测序确认,结合分离出H.pylori患者的病历资料,分析EPIYA类型与胃十二指肠疾病之间的关系。结果:292(97.3%)株为Cag A阳性,但Cag A阳性与胃十二指肠疾病病型无关(P0.5)。19例(6.51%)为不同EPIYA类型菌株混合感染,胃癌病例中混合感染出现的概率明显高于NUD者(OR=4.46,95%CI=1.17~17.03)。单一菌株感染者273株(93.49%),其中EPIYA-ABD型254株(93.04%),EPIYA分型和胃十二指肠疾病的临床病型之间无显著性差异。另外,基因测序标本中发现8株EPIYA-B基序的核苷酸序列存在基因突变。结论:该研究中EPIYA-ABD型占H.pylori感染者的绝大多数,但Cag A阳性和EPIYA-ABD型均与H.pylori感染引起的胃十二指肠疾病无关;然而胃癌患者中混合感染出现的概率明显高于非溃疡性胃炎患者。
[Abstract]:Aim: the relationship between the EPIYA sequence of carboxyl terminal of cytotoxin associated protein A (cytotoxin associated antigen A Cag A produced by Helicobacter pylori (Helicobacter pylori,H.pylori) and gastroduodenal disease has been controversial. In this study, a large number of cases with high H.pylori infection rate and high incidence of gastric cancer were collected in Chongqing, China. The polymorphism of EPIYA motif at the carboxyl end of H.pylori Cag A was detected by detecting the polymorphism of EPIYA motif at the carboxyl end of H.pylori Cag. To investigate the potential relationship between EPIYA motif and clinical gastroduodenal disease. Methods: H.pylorius was isolated from gastric mucosa of patients with dyspepsia. The 3'end region of Cag A gene was amplified by genomic DNA,PCR and typed. According to the results of typing, random sampling and sequencing were used to confirm the data of H.pylori patients. To analyze the relationship between EPIYA type and gastroduodenal disease. Results Cag A was positive in 97.3% of the strains, but Cag A was not associated with gastroduodenal disease type (P0.5). 19 cases (6.51%) were mixed infection of different EPIYA types. The probability of co-infection in gastric cancer patients was significantly higher than that in NUD patients (OR=4.46,95%CI=1.17~17.03). Among the 273 strains (93.49%) infected with single strain, there was no significant difference between EPIYA typing and clinical type of gastroduodenal disease in EPIYA-ABD type 254 (93.04%). In addition, gene mutations were found in the nucleotide sequences of EPIYA-B motifs of 8 strains. Conclusion: EPIYA-ABD type is the majority of H.pylori infected patients in this study, but both Cag A positive and EPIYA-ABD type are not associated with gastroduodenal diseases caused by H.pylori infection, but the probability of mixed infection in gastric cancer patients is significantly higher than that in non-ulcer gastritis patients.
【作者单位】：重庆医科大学附属第二医院检验科;重庆医科大学基础医学院病原生物学教研室;重庆医科大学附属第二医院感染性疾病分子生物学实验室;
【分类号】：R57

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