Serological Response to Helicobacter Pylori Infection Evaluated By Immunoblot Assay in Health Adults, Patients with Non-Ulcer Dyspepsia, Peptic Ulcer Disease, and Gastric Cancer

以免疫墨點分析法評估健康，非潰瘍性消化不良，消化性潰瘍及胃癌病患之幽門螺旋桿菌感染之血清性反應

朱光恩(Kuang-En Chu) ； 廖朝聖(Chao-Sheng Liao) ； 林裕民(Yu-Min Lin) ； 王建民(Gen-Min Wang) ； 楊國卿(Kuo-Ching Yang)

《中華民國消化系醫學雜誌》 17卷1期 (2000/03) Pp. 1-7

https://doi.org/10.6557/GJTb.200003_17(1).0001

摘要

幽門螺旋桿菌(Hp)在胃炎、消化性潰瘍與胃癌病變之病程中扮演的重要角色是眾所皆知的。本研究之目的是以西方墨點法來偵測Hp之各種抗體反應並希望了解是否可以籍著不同反應帶來推測可能導致何種消化道疾病。本前瞻性研究共收集128病例，均經上消化道內視鏡檢查分為下列5組：24例健康者，26例非潰瘍性消化不良，29例胃潰瘍，32例十二指腸潰瘍，以及17例胃癌者。健康組，非潰瘍消化不良組，及胃癌組均以尿素酶、Giemsa染色、培養再進一步分爲Hp陰性及Hp陽性(三者中二者為陽性則定義為Hp陽性；三者為陰性則定義為Hp陰性)。另外有消化性潰瘍患者均證實為Hp陽性。此外所有病例均以血清學分析作測試。本研究之血清學分析採用西方免疫墨點法(HelicoBlot 2.0, Genelabs Diagnostics, Singapore)。在血清學上幽門螺旋桿菌之認定要件為在色帶116Kd(CagA)、89kD(VacA)、35Kdk之任何一處或30kD,26.5kD中二處為陽性反應，本研究結果顯示：
(1).在台灣，由於CagA或VacA陽性菌株之盛行率甚高，我們無法以西方墨點法志測得之不同反應帶來預知不同的上消化疾病。
(2).在Hp陰性之胃癌組病人中，仍有89%可於血清學分析測得Hp之感染，顯示在這類病人中,過去可能曾經感染過Hp，由於發生萎縮胃炎，或小腸化生而使得HP不易生存,但仍可於血清中測出曾受感染之證據。值得日後更深入探討。

關鍵字

西方墨點分析法 ； 免疫墨點分析法 ； 幽門螺旋桿菌

並列摘要

It is well known that helicobacter pylori (H. pylori, Hp) Plays a role in the pathogenesis of chronic gastritis and peptic ulcer diseases. Increasing evidences emphasize the close relationship between the bacterium and gastric cancer. The aim of this study is to elucidate the pathogenic role of H. pylori can predict particular disease entities. A total of 138 patients were recruited in this prospective study and they were divided in five groups after receiving upper gastrointestinal endoscopic examination: normal control; non-ulcer dyspepsia; gastric ulcer; duodenal ulcer; and gastric cancer. The normal control, non-ulcer dyspepsia and gastric cancer groups were further divided into Hp (+) and Hp (-) subgroups, while the gastric and duodenal ulcer groups were all Hp (+). Hp (-) implies positive results in at least two of the following studies: CLO test, Giemsa stain and culture, and they were all negative in the Hp (-) subgroup. The sera of the TOTALITY OF patients were analyzed with the immunoblotting technique. Five reaction bands could be recognized: 116 kDa (CagA), 89kDa (VacA), 35kDa, 26.5 kDa and 19.5 kDa. Analyzing the seroprevalence of the antibodies to Cag-A and VacA-positive H. pylori strain is high among the patients enrolled in this study and they are not a useful marker for screening high risk patients for a determined disease. According to this study, the immunoblot assay has no predictive value in Taiwanese patients. Interestingly, 8 ort of 9 Hp(-) gastric cancer patients(89%) the immunoblot assay for the H. pylori infection was found to be positive. This finding suggests that the bacterium may not survive in a hostile gastric environment such as mucosa atrophy, but its remote infection is still detected in the serum by the immunoblot assay which emphasizes on the possible role of the H. pylori in the pathogenesis of gastric cancer. In addition, the sera of these 8 CA-Hp (-) patients with a positive immuneoblotting were further analyzed with enzyme-immune-assay (EIA) and an interesting comparison between the two tests was done.

並列關鍵字

western blot ； immunoblotting ； Helicobacter pylori