| Background&Aims: To assess the relationships between Helicobacter pylori(Hp) Cytotoxin associated antigen (CagA) status and Vacuolating cytotoxin (VacA)genotypes (s1/s2, i1/i2, m1/m2) and severity of gastric diseases in Jiangsu area.Methods: We investigated patients with various gastric diseases by culturing Hpand histopathological detection. DNA was extracted from151clinical strains and42specimens of gastric cancer. The gene expressions of CagA and VacA were analyzedby polymerase chain reaction.Results: Genotypes of193cases were obtained, the rate of the CagA+, VacA s1,VacA i1, VacA m2and VacA m1genotypes of Hp were95.9%（185/193），96.4%(186/193)，97.4%(188/193)，59.1%(114/193)，39.4%(76/193), respectively.There was no significant differences in the expression of CagA and VacA allelesamong Chronic gastritis, Peptic ulcer and Gastric cancer groups (P>0.05). There wasalso no significant relations between the genotypes and atrophy (or intestinalmetaplasia) of the gastric mucosa.180of185isolates (96.9%) had the same two cagA3’repeat regions, precluding finding any possible relationship between typing andhistological or clinical findings.Conclusion: CagA+/VacAs1i1m2was the dominant genotype of Hp in Jiangsuarea, there was no evident correlations between CagA and VacA alleles of Hp andgastric diseases. Background&Objective:H. pylori infection has also been implicated in the pathogenesis of gastroduodenaldiseases such as recurrent peptic ulceration and particularly residual stomach cancerin the postoperative stomach. To determine the performance of different commonlyused tests for the diagnosis of H. pylori infection in patients after partial gastrectomy.Methods:A systematic literature search was conducted by searching the PubMed, EMBASEand ScienceDirect databases with relevant key words. Data extraction wasindependently performed by two reviewers. Meta–analyses were performed for theperformance of the different tests including the sensitivities, specificities, likelihoodratios (LRs), diagnostic odds ratio (DOR) and the summary receiver operatingcharacteristic (SROC) curve. The meta-analysis was performed by Meta-DiScsoftware.Result:In the nine included studies assessing the urea breath test, the pooled sensitivities,specificities, LR+, LR-and DOR were0.77(95%CI,0.72-0.82; P<0.001),0.89(95%CI,0.85-0.93; P<0.001),6.32(95%CI,3.22-12.42; P=0.002),0.27(95%CI,0.17-0.43; P<0.001), and27.86(95%CI,13.27-58.49; P=0.094), respectively. In theseven included studies assessing the rapid urease test, the pooled sensitivities,specificities, LR+, LR-and DOR were0.79(95%CI,0.72-0.84; P=0.014),0.94(95%CI,0.90-0.97; P=0.095),10.21(95%CI,5.94-17.54; P=0.600) and0.28(95%CI,0.22-0.36; P=0.136) and49.02(95%CI,24.24-99.14; P=0.910), respectively. In thethree included studies assessing histological examination, the pooled sensitivities, specificities, LR+, LR-and DOR were0.93(95%CI,0.88-0.97; P=0.093),0.85(95%CI,0.73-0.93; P=0.126),5.88(95%CI,3.26-10.60; P=0.104),0.09(95%CI,0.05-0.15; P=0.278), and97.28(95%CI,34.30-275.95; P=0.772), respectively. Thecorresponding SROC curves showed areas under the curves of0.91,0.93and0.96and Q*values of0.84,0.86and0.91, respectively.Conclusion:Among the three commonly used tests, histological examination performs the best,followed by the rapid urease test, for the diagnosis of H. pylori infection after partialgastrectomy. Thus, histology, preferably after the rapid urease test, is recommendedfor the diagnosis of H. pylori infection after partial gastrectomy. |
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