| Background:Stomach cancer(GC)is the third most common cause of cancer death in men and women worldwide.More than 60% of the stomach cancer cases occur in developing countries,our country is high danger geographical area for stomach cancer occurrence.The mechanism of GC is very complex,involving many factors such as genetics,immunity,environment and Helicobacter pylori(HP)infection which play a role in different dimensions.The specificity of HP virulence factor is an important factor affecting the pathogenicity of HP.Helicobacter pylori virulence factor is mainly contributed by cytotoxin-related protein(CagA)and Vacuole cytotoxin(Vac A)genotypes,which are important markers for the typing of Helicobacter pylori.Blood lipid is an important indicator of human health,and the prevalence rate of dyslipidemia in China is as high as 40.4%.Previous epidemiological studies have shown that dyslipidemia can increase the risk of gastric cancer,and some studies have also shown that dyslipidemia is associated with Helicobacter pylori(HP)infection.Diseases closely related to gastric cancer are called pregastric diseases,including chronic atrophic gastritis,gastric ulcer,gastric polyp and residual gastritis,etc.With the continuous development of gastric mucosal lesions,intestinal metaplasia and atypical hyperplasia of gastric mucosa may occur,which are called pregastric lesions,and pregastric diseases and pregastric lesions are called pregastric states.The control of pregastric cancer is of great significance for the prevention of gastric cancer.Current studies believe that HP infection and dyslipidemia are risk factors for the occurrence of gastric cancer.However,few people have studied whether there is a correlation between Vac A,CagA and blood lipid levels in HP-ⅰ type and pregastric cancer,which provides theoretical basis for clinical prevention and treatment of gastric cancer and health management.Purpose:The purpose of this study is to investigate whether the occurrence of pregastric cancer is correlated with the levels of HP,virulence factors Vac A,CagA and lipid,and to analyze whether the levels of lipid are correlated with the levels of HP infection.Research methods:This study reviewed and analyzed the clinical data of patients with gastric diseases admitted to our department from December 2021 to December 2022.According to gastroscopy and pathological results,208 patients were diagnosed with pregastric cancer,and 232 patients with other gastric benign lesions were divided into non-pregastric cancer group.Univariate analysis was performed for the related risk factors of pregastric cancer disease,logistic regression analysis was performed for the independent risk factors of pregastric cancer disease,and ROC curve was drawn to analyze the predictive value of each independent risk factor.Then,Chi-square test was used to compare the two groups,and the expression of Vac A and CagA antibodies in the two groups were analyzed.Then,according to the typing criteria of H.pylori,the study population was divided into HP-Ⅰ,HP-Ⅱ and negative groups,including 196 HP-Ⅰ group,132HP-Ⅱ group and 112 negative group,the correlation between H.pylori typing and blood lipid level was analyzed by single factor,and the independent risk factors of HP-Ⅰ infection were analyzed.Meanwhile,the value of risk factors in predicting HP-Ⅰ type was analyzed.Result:1.Univariate analysis was performed on 440 research samples in the two groups.The main factors included gender,age,BMI,smoking history,drinking history,hypertension history,HP test,HP-Ⅰ,HP-Ⅱ,triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL)and low density lipoprotein(LDL).By one-way analysis of variance,alcohol consumption history,hypertension history,carbon 13 breath test,HP-Ⅰ,HP-Ⅱ,HDL,LDL of the pregastric cancer group were statistically significant compared with the control group(P < 0.05).2.Risk factors related to pregastric cancer disease after the above univariate analysis were taken as independent variables,and whether it was pregastric cancer disease was used as dependent variable for logistic regression analysis.The results showed that positive HP-Ⅰ,positive carbon 13 breath test,low HDL and high LDL were independent risk factors for pregastric cancer.3.The ROC curves of HP-Ⅰ,carbon 13 breath test,LDL and HDL were drawn.The results showed that HP-Ⅰ had the highest area under the curve(AUC)of 0.829,Yoden index of 0.659,sensitivity of 0.865 and specificity of 0.793.The carbon 13 breath test was followed by an AUC of 0.726,a sensitivity of 0.806 and a specificity of 0.763.The HDL AUC value was 0.709,the sensitivity was 0.798,and the specificity was 0.538.The AUC value,sensitivity and specificity of LDL level were the lowest,0.607,0.784 and 0.411,respectively.The above data differences were statistically significant(P < 0.05).4.In this study,the double-positive rate of CagA and Vac A in pregastric cancer diseases was 55.29%,which was significantly higher than that of non-pregastric cancer diseases(27.59%).The double-negative rate of CagA and Vac A in pregastric cancer diseases was 25.00%,which was significantly lower than that non-pregastric cancer disease group(52.58).The difference between groups was statistically significant(P< 0.05).5.In order to explore the correlation between the diagnosis of pregastric cancer diseases and the detection rate of HP-Ⅰ,Chi-square test was performed on the data.The results showed that the detection rates of HP-Ⅰ were 93.42%,88.46% and 70.00% in the atrophic gastritis group,gastric ulcer group and gastric polyp group,respectively,and the difference between groups was statistically significant.6.According to helicobacter pylori type Ⅰ,sample data from two groups of pregastric cancer and non-pregastric cancer were subdivided into three groups: HP-Ⅰ,HP-Ⅱ and negative.Univariate analysis was carried out with blood lipid levels,and the results showed that TG,TC,HDL and LDL were the risk factors related to HP-Ⅰ infection.Meanwhile,logistic regression analysis was carried out for the risk factors related to HP-Ⅰ infection.TG,TC,HDL and LDL were independent risk factors for HP-Ⅰinfection.The value analysis of risk factors for predicting HP-Ⅰ type showed that the AUC of HDL was the highest(0.722),the sensitivity was 0.824,and the specificity was 0.754.The second was LDL,AUC0.603,sensitivity 0.761,specificity 0.417.The above data differences were statistically significant(P <0.05).Conclusion:1.Positive HP-Ⅰ,HP test,low HDL and high LDL were independent risk factors for pregastric cancer disease,and HP-Ⅰ infection had the highest predictive value for pregastric cancer disease.2.The main pathogenic types of HP in pregastric cancer diseases are CagA and Vac A double positive antibody expression which is the most common.Ⅰ and among all diagnostic types of pregastric cancer diseases,HP has the greatest influence on the occurrence of atrophic gastritis.3.TG,TC,HDL and LDL are independent risk factors for HP-Ⅰ infection,and low HDL value is the most predictive value for HP-Ⅰ infection. |
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