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Objective To explore the relationship between Helicobacter pylori (HP) infection and gastric carcinogenesis,and to investigate its mechanism.Methods Totally 333 elderly patients with different degrees of gastric mucosal lesions in our hospital were selected.Patients were divided into 4 groups:chronic superficial gastritis group (n=86),chronic atrophic gastritis group (n=92),gastric ulcer group (n=80) and gastric cancer group (n=75).HP infection in patients were detected by paraffin-embedded tissue sections and ELISA.The gene expressions of c-myc,p16 and p53 were detected by immunohistochemical SP method,and the results were analyzed.Results HP infection positive rate was significantly higher in gastric cancer group than those in the chronic superficial gastritis group and chronic atrophic gastritis group (both P＜ 0.05).There were no significant differences in the expression rates of c-myc,p16 and p53 between HP positive and negative patients in chronic superficial gastritis group (all P＞0.05).There were differences in the expression rates of cmyc and p53 (both P＜0.05),while the expression rate of p16 had no significant difference between HP positive and negative patients in chronic atrophic gastritis group (P ＞ 0.05).There were differences in the expression rates of c-myc,p16 and p53 between HP positive and negative patients in gastric ulcer group and gastric cancer group (all P ＜ 0.05).Conclusions There is a certain correlation between Helicobacter pylori infection and gastric carcinogenesis.It is important to take anti-inflammatory treatment timely and actively to prevent gastric cancer in patients with HP infection in gastric mucosal lesions.
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BACKGROUND: Decreasing prevalence of H pylori infection has been reported in some countries. AIM: To evaluate the prevalence of Helicobacter pylori infection in a 10-year period in children submitted to upper digestive endoscopy. METHODS: It was a retrospective observational study. The records of 1,165 endoscopies performed during a 10-year period in a public hospital of the City of São Paulo, SP, Brazil, in patients up to 18-year-old. Only the first endoscopy was considered. Helicobacter pylori infection was defined by the rapid urease test, performed with one fragment of antral mucosa. Chi-square for trend has been estimated to compare Helicobacter pylori prevalence across the period. RESULTS: The main indication for endoscopy was epigastric pain (47.4 percent). There were 392 patients with H pylori infection (33.6 percent), 12.8 percent being infants, 19.4 percent toddlers, 28.8 percent schoolchildren and 46.3 percent adolescents. Prevalence was 60.47 percent in the first year of the study and 30.43 percent in the last. Among the less than 6-year-old patients there was a decrease in infection prevalence from 25 percent for the 1993-6 period to 14.3 percent in the 2000-02 period, while among the over 12-year-old patients the decrease was from 55.5 percent in the first period to 39.6 percent in the latter. The decrease in H pylori infection prevalence was more intense within patients with epigastric pain, in which prevalence has decreased from 48.2 percent (92/191) in 1993-6, to 41.9 percent (65/155) in 1997-9 and 27.7 percent (57/206) in 2000-02. CONCLUSION: The study suggests a significant decrease in the prevalence of H pylori infection regarding the studied patients. The trend was mainly observed in the younger age group and in patients with epigastric pain.
RACIONAL: Redução da prevalência de infecção por Helicobacter pylori tem sido relatada em alguns países. OBJETIVO: Avaliar, em crianças, a prevalência de infecção por H pylori em um período de 10 anos, realizando endoscopia digestiva alta. MÉTODOS: Estudo retrospectivo observacional. Os relatórios de 1.165 endoscopias digestivas altas realizadas em 10 anos em um hospital público da cidade de São Paulo, SP, foram revisados, sendo incluídas as primeiras endoscopias de pacientes com idade inferior a 18 anos. A infecção por H pylori foi definida pelo teste rápido da urease, com um fragmento de mucosa antral. RESULTADOS: A principal indicação de endoscopia foi dor epigástrica (47,4 por cento). A prevalência de infecção foi 33,6 por cento (12,8 por cento em lactentes, 19,4 por cento em pré-escolares, 28,8 por cento em escolares e 46,3 por cento em adolescentes). No primeiro ano de estudo foi 60,47 por cento, e 30,43 por cento no último. Entre os pacientes menores de 6 anos, houve diminuição na prevalência de 25 por cento (1993-6) para 14.3 por cento (2000-02), enquanto entre os pacientes maiores de 12 anos a diminuição foi de 55,5 por cento (1993-6) para 39,6 por cento (2000-02). A diminuição da prevalência foi significativa nos pacientes com dor epigástrica, nos quais passou de 48,2 por cento (92/191) em 1993-6, para 41,9 por cento (65/155) em 1997-9 e 27,7 por cento (57/206) em 2000-02. CONCLUSÃO: O estudo sugere que houve diminuição significativa na prevalência da infecção por H pylori nos pacientes estudados. A tendência foi principalmente observada no grupo etário mais jovem e nos pacientes com dor epigástrica.
Subject(s)
Adolescent , Child , Child, Preschool , Humans , Infant , Young Adult , Helicobacter pylori , Helicobacter Infections/epidemiology , Brazil/epidemiology , Gastroscopy , Helicobacter Infections/diagnosis , Prevalence , Retrospective Studies , Young AdultABSTRACT
Objective To evaluate the eradication rate and long-term therapeutic effect of a triple therapy consisted of cla-(rithromycin) (CLA), amoxicillin (AMO)and omeperazole on Hp infection,and explore the alternative therapeutic programs and their effects after first therapeutic failure.Methods A total of 92 children with Hp infection were divided into two groups: 70 children were given the triple therapy for one week (CLA group);Twenty-two children were given another triple therapy composed of metronida-(zoole) (MET), AMO and omeperazole for two weeks (MET group).All of the children were followed up for 1-30 months after the therapies ended.Children of the two groups who were therapeutic failure were given retreatment as follows.CLA triple therapy were given for one week to the children who were failure after MET triple therapy;increased doses of CLA with longer treatment course was given to the children who were failure after CLA triple therapy . A tetra therapy consisted of colloidal bismuth subcitrate (CBS), furazolidone (FUR) ,omeperazole and AMO was given to children in whom the retreatment failed.Results The Hp eradication rate of CLA group was 91.4%(64/70),and the Hp eradication rate of MET group was 72.7%(16/22).There was significant difference between eradication rate of the two groups(?~2=5.16 P
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Objective To investigate the effect of H.pylori infection and eradication on gastric parietal cell and H + K +ATPase mRNA expression in a murine model. Methods Twenty 7 week old SPF BALB/C mice (10 males and 10 females) each were fed by H.pylori strain (Sydney Strain 1,SS1) at a dose of 0.4 ml (10 9CFU) per day for consecutive 5 days. Two months after infection of H. pylori, all mice were divided into two groups, the eradication group (10 mice) and the infection group (10 mice). Mice in the eradication group were administered clarithromycin ( 13.5 mg?kg -1 ?d -1 ) twice per day for one week (one mouse was died).Meanwhile, mice in the infection group were given the same amount placebo. All mice were killed at one month after the administration.The gastric mucosa was removed for rapid urease testing (RUT) and Giemsa stainning. The expression of H + K +ATPase mRNA was detected by RT PCR. Morphological changes in parietal cells were assessed by electron microscope. Results The animals in infection group were 100% infected by H.pylori, and RUT and Giemsa staining were all positive. Meanwhile , all but one mouse in the eradcation group were negative to RUT and Giemsa staining. In the infection group, the average ratio A C to A T (A C means the area of the canaliculi, A T means the area of the parietal cells ) was ( 2.20 ? 0.06 )/10 4, significant lower than that in the eradication group [(3.20 ? 0.06 )/10 4, P