Hubungan Helicobacter Pylori Cytotoxin-Associated Gene A (CagA) Positif dan Negatif dengan Derajat Keparahan Gastritis Berdasarkan Histopatologi
Keywords:
Gastritis, H.pylori, CagA, HistopatologiAbstract
Abstract
Introduction: Helicobacter pylori (H.pylori) is the commonest cause of chronic active gastritis in the world that is around 80%. Risk of prolonged chronic gastritis into atrophy and metaplasia in gastric mucosa which leads to the occurrence of gastric cancer. H.pylori carry different virulence factors such as urease, flagellar, Vaca, and CagA, which plays an important role in the invasion, colonization and proliferation. Objective: To identify the relationship H.pylori CagA (+) and CagA (-) to the severity of gastritis by histopathology. Methods: The study was conducted with a cross-sectional design of the 30 patients with dyspepsia based on Rome III criteria, using PADYQ scores. Results: Of the 30 subjects, 18 men and 14 women with a mean age of 53.3 years, were found more subjects with gastritis H. pylori CagA (+) 21 (70%) and CagA (-) 9 (30% ). Then found a significant association between CagA status with the degree of chronic inflammation (p = 0.032) in which patients with H.pylori CagA (+) at risk of 3.43 x experiencing gastritis with chronic inflammation, the degree of infiltration of neutrophils (p = 0.037) with the risk of 4.5 x experience gastritis with infiltration of neutrophils, and the degree of atrophy (p=0.041) risk of atrophic gastritis 2.17x experiencing moderate + severe. But the absence of statistically significant relationship between CagA status with the degree of intestinal metaplasia (p = 0.077). Conclusion: There is a significant relationship between H.pylori CagA status with the degree of chronic inflammation, neutrophil infiltration degree and the degree of atrophy. There is no significant relationship between CagA status with the degree of intestinal metaplasia.
Keyword: Gastritis, H.pylori, CagA, Histopathology
Abstrak
Pendahuluan: Helicobacter pylori (H.pylori) merupakan penyebab tersering gastritis kronik aktif di seluruh dunia yaitu sekitar 80%. Gastritis kronis yang berkepanjangan beresiko menjadi atrofi dan metaplasia pada mukosa lambung yang mengarah terjadinya karsinoma gaster. H.pylori membawa faktor virulensi yang berbeda seperti urease, flagellar, VacA dan CagA yang memegang peranan penting dalam invasi, kolonisasi dan proliferasi. Tujuan: Untuk mengetahui hubungan H.pylori CagA positif dan negaatif dengan derajat keparahan gastritis berdasarkan histopatologi. Metode: Penelitian dilakukan dengan desain cross sectional terhadap 30 penderita dyspepsia berdasarkan kriteria Roma III, menggunakan PADYQ skore. Hasil: Dari 30 subyek 18 orang pria dan 14 orang perempuan dengan rerata umur 53.3 tahun, didapati lebih banyak subjek dengan gastritis H.Pylori CagA(+) 21 orang(70%) dan CagA(-) 9 orang(30%). Maka didapati hubungan yang signifikan antara status CagA dengan derajat inflamasi kronik (p=0.032) di mana pasien H. pylori dengan CagA (+) beresiko 3.43 x mengalami gastritis dengan inflamasi kronik, derajat infiltrasi neutrofil (p=0.037) dengan resiko 4.5 x mengalami gastritis dengan infiltrasi neutrofil, dan derajat atrofi (p=0.041) resiko 2.17x mengalami gastritis dengan atrofi derajat sedang+berat. Tetapi tidak didapati hubungan yang signifikan secara statistic antara status CagA dengan derajat metaplasia intestinal (p=0.077). Kesimpulan: Terdapat hubungan yang signifikan antara status H.pylori CagA dengan derajat inflamasi kronik, derajat infiltrasi neutrofil dan derajat atrofi. Tidak terdapat hubungan yang signifikan antara status CagA dengan derajat metaplasia intestinal.
Kata Kunci: Gastritis, H.pylori, CagA, Histopatologi
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