目的:比较三种检测幽门螺旋杆菌（Hp）的染色方法。方法:收集我科胃镜活检诊断为“慢性胃炎”和“胃溃疡”的蜡块42例,重新切片,分别做 HE常规染色,改良Giemsa 染色,免疫组化染色。在光镜下观察Hp的显示情况,其阳性率进行χ2检验。结果:三种染色方法的阳性率分别为HE染色:857%(36/42),改良Giemsa 染色:905%(38/42), 免疫组化: 929%(39/42)。χ2检验,免疫组化分别与其他两种染色方法比较,阳性率差异无显著性(Pgt;005)。但免疫组化Hp菌体与周围组织对比度最强,最易识别。结论:三种染色方法的阳性率无显著性差异，但采用免疫组化方法Hp菌体最易识别
Serum tumor markers CEA, CA19-9, CA72-4 and Helicobacter pylori (H.pylori) antibodies were measured in 162 patients with gastric cancer. CEA, CA19-9 and CA72-4 had sensitivities of 24.0%, 35.5% and 21.9% respectively. CA72-4 provided 100% specifity, compared to 77% and 93% for CA19-9 and CEA. The positive predictive value (PV) in CEA, CA19-9 and CA72-4 was higher than negative PV. Serum CA19-9 and CA72-4 levels rose in tumor of ＞5.0cm in diameter. The CA19-9 increased remarkably when the deeper stomach wall was invased. The significantly elevated CEA, CA72-4 and CA19-9 levels were found in patients who had nodal involvement in more than 50% and distant metastasis. However, the increase of CEA, CA19-9 and CA72-4 were found in undifferentiated tumor. Antibodies to H.pylori were detected in 54% of patients but in only 22% control subjects. A significant association was found between H.pylori infection and gastric cancer (odds ratio=3.75; 95% confidence interval=2.11-5.41, Ｐ＜0.01). Conclusions: CEA, CA19-9 and CA72-4 have higher specifity but lower sensitivity in diagnosis of the gastric cancer. The levels of CEA, CA19-9 and CA72-4 are significantly associated with the diameter, the depth of invasion, nodal involvement, distant metastasis and cell differention. Infection with H.pylori may be an important cause of gastric cancer.
Helicobacter pylori (HP) infection is closely associated with the occurrence of such common upper gastrointestinal diseases as chronic gastritis, peptic ulcer and gastric cancer. However, even with the currently most effective treatment regimens, approximately 10% to 20% of patients still fail to obtain eradication of the infection and remain HP positive. So the eradication of HP infection remains one of the major challenges in the medical field. This article aims to introduce the evidence for the choice of the second-line regimens after the failure of the first therapy. And the evidence includes the quadruple therapy proposed by the Maastricht III Consensus and the triple regimens with different antibiotics in all kinds of randomized clinical trials.
目的:了解幽门螺旋杆菌(Hp)在成都市居民中的感染情况及其相关影响因素。方法:通过幽门螺旋杆菌抗体检测成都市幽门螺旋杆菌的感染率,结合问卷调查对一些相关因素进行分析。结果:成都市Hp感染阳性率55.58%, Hp感染率与年龄呈正相关,Plt;0.02。男性和女性的Hp感染率分别为52.05%和 58.57%,两者无显著性差异(Pgt;0.05)。年收入2万元以下及年收入2万元以上者Hp感染率分别为55.44%和 61.84%,两者比较无统计学意义(Pgt;0.05)。有消化道症状者Hp感染率56.30%,无任何症状者Hp感染率55.60%(Pgt;0.05)。结论:Hp的感染率与年龄呈正相关。我们的研究未显示HP感染与性别、家庭经济收入及消化道症状有明显的关系。
Objective To clarify the role of gastrokine 1 in the process of formation and development of gastric cancer. Methods The expressions of gastrokine 1 in gastric cancer and paracancerous tissues of 52 patients with gastriccancer were detected by real-time fluorescence quantitative polymerase chain reaction （RT-PCR） and immunohistochemistry. Meanwhile the relationship of the expression level of gastrokine 1 with clinicopathologic characteristics were analyzed. Results The expression levels of gastrokine 1 gene and protein in the gastric cancer tissues were significantly lower than those in the paracancerous tissues （P＜0.01）. No significant relationship was found between expression of gastrokine 1 gene and clinicopathologic features including tumor location， depth of invasion， differentiation， lymph node metastasis， tumor stage， gender， age， and preoperative peripheral blood CEA and CA19-9 levels （P＞0.05，respectively）. What’s more， the expression level of gastrokine 1 gene in gastric cancer tissues of Helicobacter pylori （HP）-positive patients was lower than that in the negative ones （P＜0.05）. Conclusions Gastrokine 1 may play a significant role as an anti-oncogene in the process of the formation and development of gastric cancer. Its effect may become weak due to HP infection in gastric cancer patients.
Objective To investigate the expressions of monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) in gastric cancer tissues and normal gastirc mucosa tissues and the situation of helicobacter pylori (HP) infection, and detect their relationships and clinicopathologic significances. Methods Expressions of MCP-1 and VEGF were detected by immunohistochemistry in gastric cancer tissues and normal gastric mucosa tissues (5-10 cm from the mass), and HP was detected in specimen from gastric antrum by Giemsa dyeing method. Results MCP-1 and VEGF expressions in gastric cancer tissues were significantly higher than those in normal gastric mucosa tissues (P＜0.05), but there was no difference in HP positive and negative tissues included the cancer and the normal tissues （P＞0.05）. The expressions of MCP-1 and VEGF in carcinoma with tumordiameter ＞5 cm, poorly differentiated， lymph node metastasis， distant metastasis and Ⅲ+Ⅳ stage of TNM were significantly higher than those with tumor diameter ≤5 cm, well and moderately differentiated， non-lymph node metastasis， non-distant metastasis and Ⅰ+Ⅱ stage of TNM (P＜0.05). Conclusion The high expressions of MCP-1 and VEGF in gastric cancer may relate to tumor angiogenesis and metastasis, but HP infection may be irrelevant.
Objective To study the earlier and later clinic results of 64 chronic duodenal ulcer patients treated with high selective vagotomy and mucosal antrectomy (HSV+MA). Methods The clinic results of the patients and the changes of gastrin, motilin and somatostatin in the blood were prospectively investigated. Results Fifty nine (92.2%) patients after 3-6 months of follow-up and 26 (92.9%) patients after 5-8 years of follow-up achieved Visick grates Ⅰ-Ⅱ. No patients died. Gastric acid secretion and infection rate of helicobacter pylori in antral mucosa were significantly reduced after operation. No significant difference was showed in bile acids and total bacterial counts of gastric juice before and after operation. No ulcer recurrence was found by barium meal and endoscopy. There was no significant difference in serum gastrin and plasma motilin before and after operation. The level of somatostatin in the blood of patients after 5-8 years of follow-up was decreased. Conclusion HSV+MA is the better operative treatment for duodenal ulcer, since it can not only effectively and lastingly decrease acid secretion and rates of ulcer recurrence, but also preserve the function of the antrum and pylorus and keep the gastric milieu interne relatively stable.
ObjectiveTo summary the study results of the Sichuan Gastric Cancer Early Detection and Screening Research Program (SIGES). MethodsIn the past 10 years, SIGES program conducted a series of clinical and clinical epidemiological studies on the current situation and strategies of gastric cancer prevention and control in China, which provided evidence for supply-side structural reform to improve the gastric cancer prevention and control. We collected related studies and made a review. ResultsSIGES program systematically and specifically studied carcinogenic pathogens, risk factors, screening strategies, as well as critical technique and system construction of tertiary prevention for gastric cancer. The main results supported that Helicobacter pylori was highly correlated with precancerous atrophic gastritis and gastric cancer. Oncoviruses, such as Epstein-Barr virus, hepatitis B virus, human cytomegalovirus, human papillomavirus, John Cunningham virus were correlated with the risk of gastric cancer, and should be paid further attention in the prevention and screening strategy of gastric cancer. Ethnicity, domicile, and family history of gastric cancer were also correlated with gastric cancer and gastric cancer-related risk factors, so it was suggested to include in the personalized evaluation criteria system of high-risk groups for gastric cancer. ConclusionsAt present, the prevention and control of gastric cancer in China has achieved substantial achievements, but the burden of gastric cancer keeps heavy. It is still necessary to conduct further scientific research on critical technique or issues in designing prevention and control strategies.