| Objective: To explore the clinicopathological and prognostic significance of Helicobacter pylori(H.pylori) infection in gastric cancer by examining and comparing the relative infection dosage of H.pyloriin the cancerous tissues and in the adjacent non-cancerous tissues, as well as combining our early researchresults of IL-6and Stat3, to investigate the impact of H.pylori infection on IL-6/Stat3inflammatorysignaling pathways.Methods:(1) We chose118cases of patients of gastric cancer and62cases of non-cancerous tissues.Relative infection dosage of H.pylori was examined by real-time fluorescent quantitative PCR and ordinaryPCR with band optical density scanning in each group. And IL-6expression and Stat3activation wasdetected by Immunohistochemistry (SP method) in our early research.(2) We collected clinical dataincluding the follow-up information.(3) Using SPSS (version17.0) to perform statistical analysis. Therelationship of H.pylori relative infection dosage and clinical pathological parameters were analyzed usingnonparametric test (Mann-Whitney U test or Kruskal-Wallis H test). Using Mann-Whitney U test and χ2test, the different H.pylori infections and positive rate in gastric cancer and adjacent tissues were analyzed,respectively. Life table, Kaplan Meier method and Cox regression model analysis were used in analyzingthe follow-up datas. Spearman rank correlation test as well as Kruskal-Wallis H method was adopted toanalyze the relationship between H.pylori and IL-6、Stat3. All the analysis of experimental part adopteda=0.05(double side) for the test of significance level.Results:(1) The relative infection of H.pylori in non-cancerous tissues had no striking associations with allpatients’clinical pathological parameters. In gastric cancer, H.pylori was strinking related to the invasiondepth, lymph node metastasis or not and clinical staging, but not with patients’ age, gender, histologicaltype, differentiation and distant metastases conditions. The H.pylori infection dosage of T3+T4group,lymph node metastasis group and III+IV group were markedly higher than T1+T2group, non-lymph nodemetastasis group and I+II group, respectively.(2) H.pylori infection rate in cancerous tissues was higherthan the adjacent tissues. In the same patients with gastric cancer, H.pylori infection dosage in canceroustissues was higher than the non-cancerous tissues.(3) Follow-up results of118patients were as follow:62cases of live,56cases of death, and with103months, the longest life time.1,3,5,8-year survival rateswere76.3%,44.1%,35.6%and5.9%, respectively. The median overall life time was48.9months. Wedivided gastric cancer patients into three groups namely "0" group (Hp<1),"1"(1<Hp<15) and "2" group(15<Hp<27), the median life time were65.0,25.0,18.0months, respectively. Using Kaplan and Meieranalysis, indicating that H.pylori infection was negatively relevant with the total survival of gastric cancerpatients, i.e., the higher of H.pylori infection, the lower the total survival. COX, the single factor regressionmodel analysis results showed that in gastric cancer, the overall survival of patients were negativelyassociated with its age, tumor infiltration depth, lymph node metastasis or not, distant metastasis conditions,clinical stage and H.pylori relative infection (P<0.05). COX, the multi-factor regression model analysisresults indicated that the overall survival of patients with gastric cancer were negatively correlated with itsage, clinical stage, and H.pylori relative infection (P<0.05), therefore, the age, tumor clinical stage, andH.pylori relative infection can significantly increase patients’ mortality risk in gastric cancer.(4) H.pyloriinfection was significantly positively related to IL-6expression and Stat3activation, i.e., the more H.pyloriinfection, the higher IL-6expression and Stat3activation in gastric cancer.Conclusions:(1) The relative infection of H.pylori was significantly relevant with tumor invasion depth,lymph node metastasis or not and clinical staging, prompting that H.pylori infection was involved ininvasion and metastasis in gastric cancer. In the same patients with gastric cancer, H.pylori infection dosage in cancerous tissues was markedly higher than non-cancerous tissues, suggesting that H.pylori infectionmay act in the tumor’s pathogenesis and progression.(2) H.pylori infection was negatively relevant withthe total survival, indicating that the H.pylori infection may potentially serve as a clinical biomarker inevaluating the occurence and prognosis of gastric cancer.(3) H.pylori infection was obviously positivelyassociated with the IL-6expression and Stat3activation, prompting that in gastric cancer H.pylori infectionmay be involved in the development and prognosis through the IL-6/Stat3inflammatory signalingpathways. |
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