结石性胆囊炎患者胆囊黏膜组织Hp DNA及CagA和CCK-AR表达研究*

doi:10.3969/j.issn.1672-5069.2021.06.039

摘要/Abstract

摘要： 目的分析结石性胆囊炎患者胆囊黏膜组织幽门螺杆菌(Hp) DNA)及细胞毒素相关基因A(CagA)和胆囊收缩素-A受体(CCK-AR)基因水平变化。方法 2019年1月～2020年12月我院收治的98例行手术治疗的结石性胆囊炎患者,取胆囊粘膜组织行超微结构检查,采用PCR法检测胆囊黏膜Hp DNA及CagA和CCK-AR水平,采用盐酸滴定法检测胆囊黏膜磷脂酶A2(PLA2)活性。结果在透射电镜下观察,发现胆囊黏膜上皮单纯性增生33例,肠型化生45例和异型增生20例;三组胆囊黏膜Hp DNA阳性率分别为30.3%、40.0%和50.0%,差异无统计学意义(P＞0.05);单纯性增生组胆囊黏膜CagA mRNA相对水平和PLA2活性分别为(1.9±0.4)和(160.5±21.5)U/L,均显著低于肠型化生组【(3.3±0.6)和(170.9±20.4)U/L】或异型增生组【(5.1±0.9)和(188.9±22.3)U/L,P<0.05】,肠型化生组则显著低于异型增生组(P<0.05),而胆囊黏膜CCK-AR mRNA相对水平为(7.0±1.4),显著高于肠型化生组的(5.4±1.1)或异型增生组的【(2.9±0.6),P<0.05】,肠型化生组也显著高于异型增生组(P<0.05)。结论 Hp感染可能通过上调CagA表达和/或PLA2活性,而下调CCK-AR表达等方式,加速胆囊黏膜病变的进程,可能导致胆囊病变恶变。

关键词: 结石性胆囊炎, 幽门螺杆菌, 细胞毒素相关基因A, 胆囊收缩素-A受体, 超微结构

Abstract: Objective The aim of this study was to probe gallbladder mucosal tissue helicobacter pylori (Hp) infection and its toxic gene cytotoxin-associated gene A (CagA) and cholecystokinin-A receptor (CCK-AR) mRNA in patients with gallbladder calculous cholecystitis. Methods 98 patients with calculous cholecystitis were enrolled in our hospital between January 2019 and December 2020, and all patients underwent surgical removal of gallbladder. The Hp DNA in gallbladder mucosa was detected by polymerase chain reaction amplification, and the CagA and CCK-AR mRNA levels were measured by real-time fluorescent quantitative polymerase chain reaction. The activity of gallbladder mucosal phospholipase A2 (PLA2) was detected by hydrochloric titration. Results The transmission electron microscopy showed simple hyperplasia of gallbladder mucosal epithelium in 33 cases, intestinal metaplasia in 45 cases, and dysplasia in 20 cases; the gallbladder mucosa Hp DNA positive rates in simple hyperplasia, intestinal metaplasia and dysplasia group were 30.3%, 40.0% and 50.0%, respectively, without significant differences among them (P>0.05); the relative CagA mRNA level and the activity of PLA2 in patients with gallbladder mucosa dysplasia were(5.1±0.9) and (188.9±22.3)U/L, both significantly higher than [(1.9±0.4)和(160.5±21.5)U/L, respectively, P<0.05] in patients with simple hyperplasia of gallbladder mucosa or [(3.3±0.6) and (170.9±20.4)U/L, respectively, P<0.05] in patients with intestinal metaplasia of gallbladder mucosa, while the relative CCK-AR mRNA level was (2.9±0.6), significantly lower than [(7.0±1.4), P<0.05] in patients with simple hyperplasia of gallbladder mucosa or [(5.4±1.1), P<0.05] in patients with intestinal metaplasia of gallbladder mucosa. Conclusion Hp infection might accelerate the gallbladder mucosal lesion progression by up-regulating CagA mRNA levels and the activity of PLA2, while by down-regulating CCK-AR mRNA levels, which needs further investigation.

Key words: Calculous cholecystitis, Helicobacter pylori, Cytotoxin-associated gene A, Cholecystokinin-A receptor, Ultrastructure

熊茂程, 雷艳梅, 李良敏, 李杨. 结石性胆囊炎患者胆囊黏膜组织Hp DNA及CagA和CCK-AR表达研究^*[J]. 实用肝脏病杂志, 2021, 24(6): 923-926.

Xiong Maocheng, Lei Yanmei, Li Liangmin, et al. Gallbladder mucosal tissue helicobacter pylori infection and its toxic gene levels in patients with gallbladder calculous cholecystitis[J]. Journal of Practical Hepatology, 2021, 24(6): 923-926.

参考文献

[1] Akki AS, Zhang W, Tanaka KE, et al. Systematic selective sampling of cholecystectomy specimens is adequate to detect incidental gallbladder adenocarcinoma. Am J Surg Pathol, 2019, 43(12):1668-1673.
[2] 李嘉,蒋基令,黄梦黎,等.胆囊癌患者血清sVEGF-C和CEA水平变化及其与组织病理学特征的关系探讨.实用肝脏病杂志,2020,23(2):138-141.
[3] Free J, Wang F, Williams N, et al. Gallbladder mucosal lesions associated with high biliary amylase irrespective ofpancreaticobiliary maljunction. ANZ J Surg, 2018, 88(6):517-521.
[4] 朱振成,罗昆仑,刘洪,等.GOLPH3和NLRP3在胆囊癌组织中的表达及其临床意义.中华肝胆外科杂志,2020,26(11):846-849.
[5] Ari A, Tatar C,Yarikkaya E. Relationship between helicobacter pylori-positivity in the gallbladder and stomach and effect on gallbladder pathologies.J Int Med Res, 2019, 47(10):4904-4910.
[6] Zhang J, Zhang Y, Chen Y, et al. Helicobacter pylori is not a contributing factor in gallbladder polyps or gallstones: a case-control matching study of Chinese individuals. J Int Med Res, 2020, 48(10):1-11.
[7] Yu MH, Kim YJ, Park HS, et al. Benign gallbladder diseases: Imaging techniques and tips for differentiating with malignant gallbladder diseases. World J Gastroenterol, 2020, 26(22):2967-2986.
[8] Taskin OC, Basturk O, Reid MD, et al. Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions. PLoS One, 2020, 15(9):e0237979.
[9] Chu A, Liu J, Yuan Y, et al. Comprehensive analysis of aberrantly expressedceRNA network in gastric cancer with and without H.pylori infection. J Cancer, 2019, 10(4):853-863.
[10] Metman MJH, Olthof PB, van der Wal JBC, et al. Clinical relevance of gallbladder polyps; is cholecystectomy always necessary? HPB (Oxford), 2020, 22(4):506-510.
[11] ChenL, Li X, Zou T, et al . Ultrasensitive detection of H. pylori in human feces based on immunomagnetic bead capture and fluorescent quantum dots. Analyst, 2019, 144(13):4086-4092.
[12] 梁绮红,余晓琳,安胜利.定量资料非平衡设计下各组样本量对检验效能的影响.南方医科大学学报,2020,40(5):713-717.
[13] Fujii Y, Murata-Kamiya N, Hatakeyama M. Helicobacter pylori CagA oncoprotein interacts with SHIP2 to increase its delivery into gastric epithelial cells. Cancer Sci, 2020, 111(5):1596-1606.
[14] Mi Y, Dong H, Sun X, et al. The association of helicobacter pylori CagA EPIYA motifs and vacA genotypes with homologous recombination repair markers during the gastric precancerous cascade. Int J Biol Markers, 2020, 35(2):49-55.
[15] Ansari S,Akada J, Matsuo Y, et al. Epitope peptides of helicobacter pylori CagA antibodies from sera by whole-peptide mapping. J Gastroenterol, 2019, 54(12):1039-1051.
[16] Salama RI, Emara MH, Mostafa HM, et al. Helicobacter pylori infection and risk of salmonella infection. Medicine (Baltimore), 2019, 98(6):e14335.
[17] Jehanne Q, Bénéjat L, Mégraud F, et al. Evaluation of the Allplex H pylori and ClariR PCR assay for helicobacter pylori detection on gastric biopsies. Helicobacter, 2020, 25(4):e12702.
[18] Rikimaru K, Sato Y, Ito Y, et al. Is a single nucleotide polymorphism marker in the cholecystokinin a receptor gene practically suitable for improving the growth traits of Hinai-jidori chickens? J Poult Sci, 2020, 57(2):99-106.
[19] Mjønes P, Nordrum IS, Sørdal Ø, et al. Expression of the cholecystokinin-B receptor in neoplastic gastric cells. Horm Cancer, 2018, 9(1):40-54.
[20] Taskin O C, Basturk O, MD Reid, et al. Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions. PLoS One, 2020, 15(9):e0237979.
[21] Tokuyama M,Dhingra S, Polydorides AD. Clinicopathologic features and diagnostic implications of pyloric gland metaplasia in intestinal specimens. Am J Surg Pathol, 2021, 45(3):365-373.

结石性胆囊炎患者胆囊黏膜组织Hp DNA及CagA和CCK-AR表达研究^*

Gallbladder mucosal tissue helicobacter pylori infection and its toxic gene levels in patients with gallbladder calculous cholecystitis

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 7

编辑推荐

Metrics

本文评价

[1]	张佳, 晋明渊, 杜艳云, 胡秀娟, 王烈姣. NAFLD合并Hp感染患者清除治疗前后血清细胞因子水平变化^*[J]. 实用肝脏病杂志, 2021, 24(4): 500-503.
[2]	沈金勇,郭翔云,周辉,罗乐. Hp根治治疗对非酒精性脂肪性肝病患者血清细胞因子和血脂水平的影响[J]. 实用肝脏病杂志, 2020, 23(3): 364-367.
[3]	玉苏甫·吐尔逊, 赵燕霞. 小剂量二乙基亚硝胺诱导大鼠肝纤维化模型的建立[J]. 实用肝脏病杂志, 2019, 22(1): 33-36.
[4]	张海涛, 孙浩, 李凯, 许发功, 蒋汉梅. 胆汁反流性胃炎患者幽门螺杆菌感染及其胃粘膜病理学表现研究^*[J]. 实用肝脏病杂志, 2018, 21(6): 967-970.
[5]	王晓忠, 窦逾常, 王燕, 庄小芳. 慢性乙型肝炎患者幽门螺杆菌感染状况及肝组织螺杆菌属特异性16SrRNA基因分析*[J]. 实用肝脏病杂志, 2016, 19(1): 29-32.
[6]	李鑫, 何长伦. 77例门脉高压性胃病临床分析[J]. 实用肝脏病杂志, 2012, 15(5): 411-413.
[7]	杜建新, 蒋锦华, 芦红. 门脉高压性胃病患者幽门螺杆菌感染率调查[J]. 实用肝脏病杂志, 2012, 15(1): 32-36.