关键词: 幽门螺杆菌, 幽门螺杆菌抗体, 细胞毒素相关基因A, 细胞空泡毒素, 尿素酶, 胃部疾病

Abstract: Background　The prevalence of Helicobacter pylori（H.pylori）infection is high in China.But the clinical outcomes differ in the infectors，which may be associated with genetic and environmental factors，as well as the genotype of H.pylori.Objective　To explore the clinical significance of relationship between types of serum antibodies against H.pylori and gastric diseases.Methods　A total of 2 650 patients who underwent gastroscopy and H.pylori serum antibody test in Guangzhou First People's Hospital，Guangzhou Medical University，from January 2009 to December 2017 were enrolled after excluding those with previous H.pylori eradication treatment.Patients were divided into five groups based on gastroscopy and pathological results：chronic non-atrophic gastritis group（1 011 cases），chronic non-atrophic gastritis with erosion group（468 cases），gastric ulcer group（795 cases），chronic atrophic gastritis/dysplasia group（236 cases），and gastric cancer group（140 cases）.No H.pylori eradication therapy was performed in the selected patients.Serum H.pylori-specific antibodies CagA，VacA and Ure were detected by protein array.The associations of H.pylori prevalence and H.pylori types with different gastric diseases were compared among five groups.Results　The prevalence of H.pylori was 74.58%，74.34%，72.14%，71.58% and 64.49% for chronic atrophic gastritis/dysplasia，gastric ulcer，gastric cancer，chronic non-atrophic gastritis with erosion and chronic non-atrophic gastritis groups，respectively，showing a significant intergroup difference（P<0.05）.A total of 1 596 cases of H.pylori typeⅠ strains infection and 259 cases of type Ⅱ strains infection were detected.The prevalence of H.pylori type Ⅰ strains was significantly higher than that of type Ⅱ in all the groups（P<0.05）.The prevalence of H.pylori type Ⅰ differed significantly in each group（χ2=22.586，P<0.01）.The prevalence of H.pylori type Ⅰ strains in gastric ulcer group was higher than that in chronic non-atrophic gastritis/dysplasia group（P<0.005）.Among the 1 596 patients with H.pylori type Ⅰ strains，CagA+VacA antibody accounted for 60.15%（960/1 596），followed by VacA antibody，accounting for 34.27%（547/1 596），and CagA antibody accounted for 5.58%（89/1 596）.The prevalence of CagA+VacA antibody was higher than that of CagA and VacA antibody in each group，the prevalence of VacA antibody was higher than that of CagA antibody（P<0.05）.The prevalence of CagA antibody differed significantly in each group（χ2=19.054，P<0.01），and the gastric ulcer group was higher than the chronic non-atrophic gastritis group（P<0.005）.The prevalence of VacA antibody differed significantly in each group（χ2=20.204，P<0.01），and the chronic non-atrophic gastritis group was lower than the chronic non-atrophic gastritis with erosion group and gastric ulcer group（P<0.005）.The prevalence of Ure antibody differed significantly in each group（χ2=63.967，P<0.01），and the prevalence of Ure antibody in chronic non-atrophic gastritis group was higher than that in gastric ulcer group and chronic atrophic gastritis/dysplasia group and gastric cancer group（P<0.005）；chronic non-atrophic gastritis with erosion group was higher than gastric ulcer group，chronic atrophic gastritis/dysplasia group，gastric cancer group（P<0.005）.Conclusion　H.pylori infection is closely related to gastric lesions.Different types of H.pylori infection have different pathogenicity.Type Ⅰ strains are the main pathogenic strain of gastric diseases，while the co-expression of both CagA and VacA is most prevalent.

Key words: Helicobacter pylori, Helicobacter pylori antibody, Cytotoxin-associated gene A, Vacuolating cytotoxin A, Urease, Gastric diseases