Study On The Relationship Between The Helicobacter Pylori VacA And Intestinal Metaplasia Of Gastric Mucosa

ObjectiveTo investigate the relationship between H.pylori vacA genotype and different gastric diseases with IM to block clinical process of atrophic gastritis IM and approve the new target of clinical treatment.MethodsIn this study,396 cases of paraffin-embedded specimens were collected from the Affiliated Hospital of Shenyang Medical College and the Second Affiliated Hospital of Shenyang Medical College from 2011 to 2014.271 cases were H.pylori positive,233 case were carried vacA gene.71 cases of superficial gastritis(GS),49 cases of atrophic gastritis(GA),113 cases of gastric ulcer(GU).We found 82 cases with IM(GS = 18,GA = 35,GU = 29),and 151 patients without IM(GS = 53,GA =14,GU=84).Using HE staining and methylene blue staining to diagnosis the specimens.Histopathologic diagnosis of specimens using HE and methylene blue staining.To extract the paraffin embedded gastroscope tissue DNA by using the DNA Extraction Kit.H.pylori infection was determined by PCR and histological staining,H.pylori vacA was amplificated by nested PCR method.MUC2 and MUC5AC expression levels immunohistochemisted stain.The IM was by HID-ABpH2.5-PAS staining.The level of statistical was set at 0.05 and all tests were ?2 or Fisher exact test,All analyses were performed with SPSS 16.0.ResultsThe expression level of vacA slm-subtype was the highest in GS,while vacA slmlm2 in GU,the vac A s1 m2 subtype in GA.The predominant vacA genotype in GA was m2(38.8%),which was higher than that in GS and GU groups.The predominant vacA genotype in GA was m2(38.8%),which was higher than that in GS and GU groups.The difference was statistically significant.The relationship between the different vacA gene subtypes and IM.The predominant vacA genotype in IM was m2(42.7%),which was higher than non IM.The predominant vacA genotype in IM was slm2(41.5%),which was higher than that in non IM groups.The difference was statistically significant.The constituent ratio of s1m1 subtype in non IM group was 29.1%was significantly higher than that in IM group,which was higher than that of other subtypes.In the IM group,the m2 subtype was 54.3%(19/35)significantly higher than that of the other subtypes,and higher than the GS and GU.In the GA cases in the IM group,s1 m2 subtype of the composition ratio of 54.3%(19/35),significantly higher than other genotype combinations,but also higher than the IM group GS and GU.The relationship between different vacA gene subtypes and the expression of MUC2 was compared.We found 107 cases of MUC2 positive cases and 126 cases of negative cases.In the MUC2-positive group,the m2 subtype was 36.4%(39/107),which was significantly higher than the ml subtype and higher than the negative subgroup.The s1m2 subtype was 35.5%107),higher than the slm2 subtype in the MUC2 negative group.The difference was statistically significant.The relationship between different vacA gene subtypes and MUC5AC expression was compared.We found 89 cases of MUC5AC positive cases and 144 cases of negative cases.In the MUC5AC positive group,the m2 subtype was 14.6%(13/89),which was significantly lower than that of the ml subtype.It was significantly lower than the m2 subtype of the negative group.In the MUC5AC positive group,the slm2 subtype was 14.6%,which was significantly lower than that of slml subtype,and was significantly lower than that of s1m2 subtype in the negative group.The relationship between different vacA gene subtypes and IM clones was stained with HID-AB-PAS-PH2.5,and 82 were complete in 82 cases with incomplete IM and 59 in incomplete IM.The m2 subtype in the incomplete IM group was 50.8%(30/59),higher than the ml subtype of the same group,and higher than the complete IM,vacA s1 m2 subtype in the incomplete IM group was 49.2%(29/59),higher than that of the same group s1m1 subtype,and higher than the complete IM.The difference was statistically significant.Conclusions1.The vacA m2 and vacA s1m2 were the predominant subtype infection in GA,Infection of vacA m2 and s1m2 of H.pylori may increase the risk of GA.2.The vacA m2 and vacA slm2 were the predominant subtype infection in IM,Infection of vacA m2 and s1m2 of H.pylori may increase the risk of IM.3.Compared with complete IM,H.pylori was infected in incomplete IM,m2 and s1m2,were predominant subtype in IM.