Abstract：
The combination of the four regions of vacA with cagA, cagE, dupA genes and cagA-EPIYA motifs, was studied to find the most likely combination that can be used as a disease determinant marker in Moroccan population. A total of 838 H. pylori positive obtained from consenting patients, that were previously analyzed by PCR to characterize vacA-s -m, -i regions, cagE status and cagA 3\' region polymorphism, were used to characterize vacA-d region and to determine dupA gene status. The analysis shows the predominance of the less virulent combination (vacA(s2m2i2d2)dupA(-)cagE(-)cagA(-)), and shows that the risk of gastric cancer is 13.33 fold higher (1.06-166.37)) in patients infected by strains harboring vacA(s1m1i1d1)dupA(-)cagE(+)cagA(2EPIYA-C) compared to patients with gastritis without lesions and infected by H.pylori strains harboring vacA(s2m2i2d2)dupA(-)cagE(-)cagA(-). The infection with strains harboring vacA(s1m1i1d1)dupA(+)cagE(+)cagA(1EPIYAC) genotype combination represents a risk factor for gastric ulcer and duodenal ulcer (the Odds Ratio (95% CI) were 16 (1.09-234.24) and 6.54 (1.60-26.69) respectively) compared to patients with gastritis without lesions. These results suggest that the combination of the active form of vacA genotypes, dupA gene status and the number of EPIYA-C motif may be considered helpful markers to discriminate between several gastric diseases.
摘要：
vacA与cagA的四个区域的组合，cagE,dupA基因和cagA-EPIYA基序，进行了研究，以找到可用作摩洛哥人群疾病决定因素标记的最可能组合。从同意的患者中获得了838例幽门螺杆菌阳性，先前通过PCR分析以表征vacA-s-m，-i地区，cagE状态和cagA3'区域多态性，用于表征vacA-d区域并确定dupA基因状态。分析显示了毒性较小的组合(vacA(s2m2i2d2)dupA(-)cagE(-)cagA(-))的优势，并显示，与携带vacA（s1m1i1d1）dupA（-）cagE（）cagA（2EPIYA-C）的菌株感染的患者相比，患有胃癌的风险高13.33倍（1.06-166.37）。无病变的胃炎和被携带vacA（s2m2i2d2）dupA（-cagE）的幽门螺杆菌菌株感染。携带vacA（s1m1i1d1）dupA（）cagE（）cagA（1EPIYAC）基因型组合的菌株感染是胃溃疡和十二指肠溃疡的危险因素（赔率（95％CI）分别为16（1.09-234.24）和6.54（1.60-26.69））。这些结果表明，vacA基因型的活性形式的组合，dupA基因状态和EPIYA-C基序的数量可能被认为是区分几种胃病的有用标记。
