幽门螺旋杆菌感染与胃癌部位和类型的关系

目的　探讨幽门螺旋杆菌 (Hpylori)感染与胃癌的部位和不同类型之间的关系。方法　根据内镜所见和Bor rmann分型对 10 9例胃癌的部位和类型进行诊断。用ABpH2 .5 PAS及HE染色区别肠型和弥漫型胃癌。用AgNOR嗜银染色法检查胃癌及癌旁黏膜胃镜活检标本Hpylori感染状况。 结果　胃癌组织内无Hpylori存在。非贲门癌癌旁黏膜Hpylori感染率 (6 6 .2 % )高于贲门癌 (4 3.8% ) (P <0 .0 5 )。H pylori在Ⅱ型和Ⅲ型胃癌旁黏膜阳性率(6 2 .5 % )与Ⅰ型 (5 3.8% )和Ⅳ型 (5 9.3% )比较均无显著性差异 ,肠型和弥漫型胃癌旁粘膜Hpylori阳性率分别为6 5 .4 %和 5 4 .4 % (P >0 .0 5 )。慢性活动和非活动性胃炎 ,H pylori阳性和阴性胃炎在两组的分布频率无差异。结论　Hpylori感染与非贲门癌关系密切 ,与癌溃疡无关。慢性胃炎尤其是H pylori阳性胃炎是发生肠型和弥漫型胃癌的基础病变 ,Hpylori是重要的始动因子

Relationship of Helicobacter pylori infection with location and type of gasteric cancer

Objective To investigate the relationship of Helicobacter pylori (H pylori) infection with locations and types of gastric cancer. Methods According to the endoscopic findings and Borrmann classification, the location and type of 109 adenocarcinoma of the stomach were diagnosed. ABpH2.5-PAS and hematoxylin and eosin staining methods were used to discriminate intestinal-type carcinoma from diffuse-type carcinoma according to Lauren classification. AgNOR staining was carried out to detect H pylori in gastric biopsy specimens of the cancerous tissues and mucosa adjacent to malignant lesions. Results H pylori was not identified over the tumor areas. The H pylori infection rate in mucosa adjacent to non-cardiac gastric cancer (66.2%) was significantly higher than that in cardiac gastric cancer (43.8%) (χ 2=4.75, P<0.05). H pylori positive rate in mucosa adjacent to type Ⅱ and type Ⅲ carcinoma (62.5%) was not significantly higher than that in type Ⅰ(53.8%) as well as type Ⅳ carcinoma (59.3%) (χ 2=0.08, 0.55, P>0.05). H pylori positive rate in mucosa adjacent to intestinal-type carcinoma and diffuse-type carcinoma was 65.4% and 54.4%, respectively, and no significant difference was found (χ 2=1.37, P>0.05). Chronic active and non-active gastritis, H pylori positive and negative chronic gastritis occurred equally frequently in the two groups (χ 2=1.31, 1.37, P>0.05). Conclusion H pylori infection is closely related with non-cardiac gastric cancer. There is no relationship between H pylori infection and cancerous ulcer. Chronic gastritis, especially H pylori positive one, is the primary disease for developing intestinal-type and diffuse-type carcinoma, and H pylori may be an important initiating factor.