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Serologic detection of CagA positive Helicobacter pylori in patients with different gastroduodenal diseases

الكشف المصلي عن الملوية البوابية إيجابية الـCagA عند المرضى المصابين بأمراض معدية عفجية مختلفة

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 Publication date 2013
and research's language is العربية
 Created by Shamra Editor




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This study aimed to know the relation between cagA positive Helicobacter pylori (HP) strains and diseases such as gastric and duodenal ulcers and gastric adenocarcinoma. The study included 61 dyspeptic patients from gastrointestinal (GI) endoscopy department patients in Al-Assad university hospital in Lattakia. During upper (GI) endoscopy, gastric biopsy specimens were obtained for Clo-test and histologic examination. Blood was obtained from Clo-test positive patients for serologic tests of HP and cagA. After upper (GI) endoscopy and histologic examination, patients were divided into 4 groups: chronic gastritis (28 patients), gastric ulcer (5 patients), duodenal ulcer (17 patients) and gastric adenocarcinoma (11 patients). CagA antibodies were positive in 68.85% of patients. The difference in the proportion of CagA antibody positive between the four groups was highly significant (P= 0.006). The highest positive proportion was in gastric adenocarcinoma (90.91%) then duodenal ulcer (88.24%) then gastric ulcer (80%), while the lowest positive proportion was in chronic gastritis (46.43%). There was no difference in HP antibody levels between the four groups (P = 0.90) but these levels were significantly higher in cagA+ patients compared to cagA- (P= 0.05). This study found a positive relation between cagA+ and diseases such as peptic ulcer and gastric adenocarcinoma in Syria .


Artificial intelligence review:
Research summary
هدفت هذه الدراسة إلى معرفة العلاقة بين ذراري الملوية البوابية (HP) إيجابية الـ cagA والقرحة المعدية والعفجية وسرطان المعدة الغدي. شملت الدراسة 61 مريضاً مصاباً بعسر الهضم من المرضى المراجعين لقسم التنظير الهضمي في مشفى الأسد الجامعي في اللاذقية. تم أخذ خزعات معدية لإجراء اختبار الـ Clo-test والفحص النسيجي، وتم سحب الدم للمرضى إيجابيي الـ Clo-test لإجراء الاختبارات المصلية لـ HP وcagA. بعد إجراء التنظير الهضمي العلوي والفحص النسيجي، تم توزيع المرضى على 4 مجموعات: التهاب المعدة المزمن (28 مريضاً)، القرحة المعدية (5 مرضى)، القرحة العفجية (17 مريضاً)، وسرطان المعدة الغدي (11 مريضاً). كانت أضداد الـ CagA إيجابية عند 68.85% من مرضى الدراسة، وكانت أعلى نسبة إيجابية بين مرضى سرطان المعدة الغدي (90.91%)، تلتها القرحة العفجية بنسبة 88.24%، ثم القرحة المعدية بنسبة 80%، بينما كانت أقل نسبة إيجابية بين مرضى التهاب المعدة المزمن (46.43%). خلصت الدراسة إلى وجود علاقة إيجابية بين الـ cagA والقرحة الهضمية وسرطان المعدة الغدي في سوريا.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تسلط الضوء على العلاقة بين ذراري الملوية البوابية إيجابية الـcagA والأمراض الهضمية المختلفة، مما يساهم في فهم أفضل للعوامل المسببة لهذه الأمراض. ومع ذلك، يمكن انتقاد الدراسة من ناحية حجم العينة الصغير نسبياً (61 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. كما أن الدراسة اقتصرت على منطقة جغرافية واحدة (اللاذقية)، مما قد يحد من إمكانية تطبيق النتائج على نطاق أوسع. كان من الممكن أيضاً تحسين الدراسة بإجراء مقارنة مع مجموعة ضابطة من الأفراد الأصحاء لتحديد الفروق بشكل أكثر دقة.
Questions related to the research
  1. ما هي الأهداف الرئيسية لهذه الدراسة؟

    هدفت الدراسة إلى معرفة العلاقة بين ذراري الملوية البوابية إيجابية الـcagA والقرحة المعدية والعفجية وسرطان المعدة الغدي.

  2. ما هي نسبة إيجابية أضداد الـcagA بين مرضى سرطان المعدة الغدي؟

    كانت نسبة إيجابية أضداد الـcagA بين مرضى سرطان المعدة الغدي 90.91%.

  3. ما هي الفئات الأربعة التي تم توزيع المرضى عليها في الدراسة؟

    تم توزيع المرضى على أربع فئات: التهاب المعدة المزمن، القرحة المعدية، القرحة العفجية، وسرطان المعدة الغدي.

  4. ما هو الانتقاد الرئيسي الذي يمكن توجيهه لهذه الدراسة؟

    الانتقاد الرئيسي هو حجم العينة الصغير نسبياً (61 مريضاً فقط) والاقتصار على منطقة جغرافية واحدة (اللاذقية)، مما قد يؤثر على تعميم النتائج.


References used
KUSTERS, J. G.; VLIET, A. M.; KUIPERS, E. J. Pathogenesis of Helicobacter pylori Infection. Clin Microbiol Rev. 2006 July; 19(3): 449–490
BLASER, M. J.; ATHERTON, J. C. Helicobacter pylori persistence: biology and disease. J. Clin. Investig. 2004. 113:321-333
LEUNK, R. D.; JOHNSON, P. T.; DAVID, B. C.; KRAFT, W. G.; MORGAN, D. R. Cytotoxic activity in broth-culture filtrates of Campylobacter pylori. J. Med. Microbiol. 1988. 26:93-99
COVACCI, A.; CENSINI, S.; BUGNOLI, M.; PETRACCA, R.; BURRONI, D.; MACCHIA, G.; MASSONE, A.; PAPINI, E.; XIANG, Z.; FIGURA, N.; RAPPUOLI, R. Molecular characterization of the 128-kDa immunodominant antigen of Helicobacter pylori associated with cytotoxicity and duodenal ulcer. Proc. Natl. Acad. Sci. USA, 1993. 90:5791-5795
CHING, C. K.; WONG, B. C.; WOK, E. K.; ONG, L.; COVACCI, A.; LAM, S. K. Prevalence of CagA-bearing Helicobacter pylori strains detected by the anti-CagA assay in patients with peptic ulcer disease and in controls. Am. J. Gastroenterol. 1996. 91:949-953
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