We explored the clinical-stage association of gastric intestinal metaplasia (IM) compared to cases of chronic non-atrophic gastritis (CNAG) and its relationship with virulence genotypes ofHelicobacter pylori(H. pylori) clinical isolates from patients with dyspepsia in Peru. This study was cross-sectional and included 158H. pyloriclinical isolates; each isolate corresponded to a different Peruvian patient, genotyped by polymerase chain reaction to detectcagAgene and EPIYA motifs, thevacAgene (alleless1,s2,i1,i2,d1,d2,m1,m2and subtypess1a,s1bands1c), theiceAgene (alleles1and2), and thebabAgene (allele2). We observed that 38.6% presented with IM and that all clinical isolates wereCagApositive. The EPIYA-ABC motif was predominant (68.4%), and we observed a high frequency for thevacAgene alleless1(94.9%),m1(81.7%),i1(63.9%), andd1(70.9%). Strains with bothiceAalleles were also detected (69.6%) and 52.2% werebabA2positive. In addition, it was observed that thecagA+/vacAs1m1(PR: 2.42, 1.14 to 5.13,p< 0.05) andcagA+/vacAs1am1(PR: 1.67, 1.13 to 2.45,p< 0.01) genotypes were associated with IM. Our findings revealed thecagAandvacArisk genotypes predominance, and we provided clinically relevant associations between Peruvian patients withH. pyloriinfection and IM clinical stage.
本研究旨在探讨秘鲁消化不良患者中，胃黏膜肠上皮化生（IM）与慢性非萎缩性胃炎（CNAG）的临床分期关联，及其与幽门螺杆菌临床分离株毒力基因型的关系。该横断面研究共纳入158株幽门螺杆菌临床分离株，每株对应一名不同的秘鲁患者，通过聚合酶链式反应对以下基因进行分型：cagA基因及EPIYA基序、vacA基因（等位基因s1、s2、i1、i2、d1、d2、m1、m2及亚型s1a、s1b和s1c）、iceA基因（等位基因1和2）以及babA基因（等位基因2）。结果显示，38.6%的患者存在IM，所有临床分离株均为CagA阳性。EPIYA-ABC基序占主导地位（68.4%），vacA基因等位基因s1（94.9%）、m1（81.7%）、i1（63.9%）和d1（70.9%）出现频率较高。同时检测到携带两种iceA等位基因的菌株（69.6%），52.2%为babA2阳性。此外，研究发现cagA+/vacA s1m1（PR: 2.42，1.14-5.13，p < 0.05）和cagA+/vacA s1am1（PR: 1.67，1.13-2.45，p < 0.01）基因型与IM存在关联。本研究揭示了cagA和vacA风险基因型在秘鲁幽门螺杆菌感染患者中的优势分布，并提供了该人群幽门螺杆菌感染与IM临床分期之间具有临床相关性的关联证据。
肿瘤(癌症)患者之家