幽门螺杆菌是胃十二指肠疾病的最常见原因。cagA阳性幽门螺杆菌是胃癌危险因素的概念似乎仅适用于来自西方国家的幽门螺杆菌菌株。在发病过程中,其他毒力基因可能与cagA具有协同作用。本研究旨在调查幽门螺杆菌cagA,vaca,和icea的流行,基因型,以及它们与越南患者临床结局的关联。使用PCR技术对从141例胃十二指肠疾病患者的胃活检中提取的DNA确定了cagA状态以及vacA和iceA基因型。在对cagA进行分子分析后,vaca,和一个基因,混合幽门螺杆菌菌株的样品,积极性,或者对于cagA和cagPAI空站点都是否定的,或未鉴定的基因型被排除。最后,107个样本被检查。CagA的存在,vaca,并且在77.6%中检测到了iceA基因,100%,80.4%的病例,分别。值得注意的是,带有EPIYA-ABD的cagA(+),vacAs1i1m1、vacAs1i1m2、iceA1和iceA2占73.8%,44.9%,33.6%,48.6%,31.8%的病例,分别。四种iceA2亚型(24-aa,59-aa,94-aa,和129-aa变体)被发现,59-aa变体最普遍(70.6%)。在26.2%和25.1%的病例中发现了cagA(+)/vacAs1i1m1/iceA1和cagA(+)/vacAs1i1m2/iceA1的组合,分别。进行了多变量逻辑回归分析,在调整了年龄和性别后,以胃炎组作为参考对照。在vacAs1i1m2基因型之间发现了统计学上显著的关联,iceA1变体,和cagA(+)/vacAs1i1m2/iceA1组合和胃癌;调整后的OR估计为18.02(95%CI:3.39-95.81),4.09(95%CI:1.1-15.08),和16.19(95%CI:3.42-76.66),分别。有趣的是,第一次,我们的研究发现vacAs1i1m2,而vacAs1i1m1不是胃癌的危险因素。这项研究说明了幽门螺杆菌cagA的遗传多样性,vaca,和iceA基因跨地理区域,有助于理解这些基因型对临床结果的重要性。
Helicobacter pylori is the most common cause of gastroduodenal diseases. The concept that cagA-positive H. pylori is a risk factor for gastric cancer appears to be true only for H. pylori strains from Western countries. Other virulent genes may have a synergistic interaction with cagA during pathogenesis. This
study aims to investigate H. pylori cagA, vacA, and iceA prevalence, genotypes, and their association to clinical outcomes in Vietnamese patients. The cagA status and vacA and iceA genotypes were determined using the PCR technique on DNA extracted from gastric biopsies of 141 patients with gastroduodenal diseases. After performing molecular analysis for cagA, vacA, and iceA genes, samples with mixed H. pylori strains, positivity, or negativity for both cagA and cagPAI-empty site, or unidentified genotypes were excluded. Finally, 107 samples were examined. The presence of the cagA, vacA, and iceA genes were detected in 77.6%, 100%, and 80.4% of cases, respectively. Notably, cagA( +) with EPIYA-ABD, vacA s1i1m1, vacA s1i1m2, iceA1, and iceA2 accounted for 73.8%, 44.9%, 33.6%, 48.6%, and 31.8% of cases, respectively. Four iceA2 subtypes (24-aa, 59-aa, 94-aa, and 129-aa variants) were found, with the 59-aa variant the most prevalent (70.6%). The cagA( +)/vacAs1i1m1/iceA1 and cagA( +)/vacAs1i1m2/iceA1 combinations were found in 26.2% and 25.1% of cases, respectively. A multivariable logistic regression analysis was performed, after adjusting for age and gender, with the gastritis group was used as a reference control. Statistically significant associations were found between the vacA s1i1m2 genotype, the iceA1 variant, and the cagA( +)/vacAs1i1m2/iceA1 combination and gastric cancer; the adjusted ORs were estimated as 18.02 (95% CI: 3.39-95.81), 4.09 (95% CI: 1.1-15.08), and 16.19 (95% CI: 3.42-76.66), respectively. Interestingly, for the first time, our
study found that vacA s1i1m2, but not vacA s1i1m1, was a risk factor for gastric cancer. This
study illustrates the genetic diversity of the H. pylori cagA, vacA, and iceA genes across geographical regions and contributes to understanding the importance of these genotypes for clinical outcomes.