{"id":19209,"date":"2023-04-13T16:11:18","date_gmt":"2023-04-13T09:11:18","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19209"},"modified":"2023-04-13T18:29:02","modified_gmt":"2023-04-13T11:29:02","slug":"moi-quan-he-giua-helicobacter-pylori-va-ung-thu-da-day","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/13\/moi-quan-he-giua-helicobacter-pylori-va-ung-thu-da-day\/","title":{"rendered":"M\u1ed1i quan h\u1ec7 gi\u1eefa Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y"},"content":{"rendered":"<p><strong>K\u1ec3 t\u1eeb khi \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0o kho\u1ea3ng th\u1eadp ni\u00ean 80 c\u1ee7a th\u1ebf k\u1ef7 XXI, ng\u00e0y c\u00e0ng c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u v\u1ec1 m\u1ed1i quan h\u1ec7 gi\u1eefa xo\u1eafn khu\u1ea9n Helicobacter pylori (HP) n\u00e0y v\u00e0 c\u00e1c b\u1ec7nh l\u00fd c\u1ee7a tr\u00ean c\u01a1 th\u1ec3 con ng\u01b0\u1eddi. C\u01a1 quan Nghi\u00ean c\u1ee9u Ung th\u01b0 Qu\u1ed1c t\u1ebf \u0111\u00e3 tuy\u00ean b\u1ed1 r\u1eb1ng HP l\u00e0 thu\u1ed9c t\u00e1c nh\u00e2n sinh ung th\u01b0 nh\u00f3m I \u0111\u1ed1i v\u1edbi ung th\u01b0 bi\u1ec3u m\u00f4 tuy\u1ebfn d\u1ea1 d\u00e0y (gastric adenocarcinoma). C\u0169ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y nhi\u1ec5m HP \u00a0l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a lymphoma li\u00ean quan ni\u00eam m\u1ea1c \u00a0(MALT lymphoma) \u1edf d\u1ea1 d\u00e0y.<\/strong><\/p>\n<figure id=\"attachment_19275\" aria-describedby=\"caption-attachment-19275\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19275\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-man-hinh-2023-04-12-luc-5.18.50-CH-1-300x203.png\" alt=\"minh-hoa-nhiem-hp\" width=\"300\" height=\"203\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-man-hinh-2023-04-12-luc-5.18.50-CH-1-300x203.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-man-hinh-2023-04-12-luc-5.18.50-CH-1-768x521.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-man-hinh-2023-04-12-luc-5.18.50-CH-1.png 1012w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19275\" class=\"wp-caption-text\">Minh h\u1ecda xo\u1eafn khu\u1ea9n Helicobacter pylori<\/figcaption><\/figure>\n<h2>1. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a vi khu\u1ea9n Helicobacter pylori<\/h2>\n<p>Helicobacter pylori l\u00e0 m\u1ed9t lo\u00e0i vi khu\u1ea9n c\u00f3 t\u00ednh ch\u1ea5t vi sinh \u0111\u1eb7c bi\u1ec7t th\u00edch nghi t\u1ed1t v\u1edbi m\u00f4i tr\u01b0\u1eddng s\u1ed1ng c\u1ee7a ch\u00fang. \u0110\u00e2y l\u00e0 m\u1ed9t vi khu\u1ea9n gram \u00e2m c\u00f3 h\u00ecnh d\u1ea1ng xo\u1eafn v\u00e0 \u0111\u01b0\u1ee3c trang b\u1ecb nhi\u1ec1u roi \u0111\u1ec3 di chuy\u1ec3n. HP \u00a0c\u00f3 kh\u1ea3 n\u0103ng s\u1ed1ng trong m\u00f4i tr\u01b0\u1eddng d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng c\u00f3 \u0111\u1ed9 axit r\u1ea5t cao v\u00e0 \u0111\u00e3 ph\u00e1t tri\u1ec3n nhi\u1ec1u c\u01a1 ch\u1ebf \u0111\u1ec3 s\u1ed1ng s\u00f3t trong m\u00f4i tr\u01b0\u1eddng kh\u1eafc nghi\u1ec7t n\u00e0y. M\u1ed9t trong nh\u1eefng c\u01a1 ch\u1ebf n\u00e0y l\u00e0 s\u1ea3n xu\u1ea5t urease, m\u1ed9t enzyme ph\u00e2n hu\u1ef7 urea th\u00e0nh amoni, gi\u00fap trung h\u00f2a axit xung quanh v\u00e0 t\u1ea1o m\u00f4i tr\u01b0\u1eddng ki\u1ec1m h\u01a1n, thu\u1eadn l\u1ee3i cho s\u1ef1 s\u1ed1ng c\u1ee7a vi khu\u1ea9n. H\u1ed9i ngh\u1ecb \u0111\u1ed3ng thu\u1eadn Vi\u1ec7n Y t\u1ebf qu\u1ed1c gia c\u1ee7a Hoa K\u1ef3 (National Institutes of Health Consensus Conference) c\u00f4ng nh\u1eadn HP l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n g\u00e2y lo\u00e9t d\u1ea1 d\u00e0y v\u00e0 t\u00e1 tr\u00e0ng t\u1eeb n\u0103m 1994.<\/p>\n<p>Ngo\u00e0i urease, HP c\u00f2n c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 g\u00e2y b\u1ec7nh kh\u00e1c gi\u00fap vi khu\u1ea9n n\u00e0y x\u00e2m nh\u1eadp v\u00e0 t\u1ed3n t\u1ea1i trong ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y. Bao g\u1ed3m c\u00e1c ch\u1ea5t k\u1ebft d\u00ednh gi\u00fap vi khu\u1ea9n g\u1eafn k\u1ebft v\u00e0o t\u1ebf b\u00e0o ch\u1ee7, c\u0169ng nh\u01b0 c\u00e1c enzyme v\u00e0 \u0111\u1ed9c t\u1ed1 kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng m\u00f4 ch\u1ee7 v\u00e0 g\u00e2y ra ph\u1ea3n \u1ee9ng vi\u00eam trong l\u1edbp ni\u00eam m\u1ea1c c\u1ee7a d\u1ea1 d\u00e0y. HP c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng bi\u1ebfn th\u1ec3 kh\u00e1ng nguy\u00ean, gi\u00fap n\u00f3 tr\u00e1nh \u0111\u01b0\u1ee3c h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a k\u00fd ch\u1ee7 v\u00e0 t\u1ed3n t\u1ea1i trong ni\u00eam m\u1ea1c d\u1ea1 d\u00e0y trong th\u1eddi gian d\u00e0i. Gen c\u1ee7a HP \u00a0c\u00f3 t\u00ednh linh ho\u1ea1t cao, n\u00f3 c\u00f3 th\u1ec3 nhanh ch\u00f3ng ti\u1ebfp nh\u1eadn hay truy\u1ec1n t\u1ea3i v\u1eadt li\u1ec7u di truy\u1ec1n th\u00f4ng qua truy\u1ec1n gen ngang. T\u00ednh n\u0103ng n\u00e0y \u0111\u01b0\u1ee3c cho l\u00e0 g\u00f3p ph\u1ea7n v\u00e0o kh\u1ea3 n\u0103ng HP th\u00edch nghi v\u1edbi m\u00f4i tr\u01b0\u1eddng thay \u0111\u1ed5i v\u00e0 ph\u00e1t tri\u1ec3n c\u00e1c ch\u1ee7ng \u0111\u1ec1 kh\u00e1ng kh\u00e1ng sinh.<\/p>\n<h2>2. M\u1ed1i quan h\u1ec7 c\u1ee7a Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y<\/h2>\n<h3>2.1 Vai tr\u00f2 c\u1ee7a Helicobacter pylori trong sinh b\u1ec7nh h\u1ecdc ung th\u01b0 d\u1ea1 d\u00e0y<\/h3>\n<p>M\u1ed9t s\u1ed1 gi\u1ea3 thuy\u1ebft v\u00e0 m\u00f4 h\u00ecnh th\u1ef1c nghi\u1ec7m \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra \u0111\u1ec3 gi\u1ea3i th\u00edch vai tr\u00f2 c\u1ee7a HP trong qu\u00e1 tr\u00ecnh ung th\u01b0, tuy nhi\u00ean c\u01a1 ch\u1ebf ch\u00ednh x\u00e1c v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5 ho\u00e0n to\u00e0n. T\u00ednh ch\u1ea5t vi sinh c\u1ee7a HP n\u00f3i chung v\u00e0 c\u00e1c ch\u1ee7ng ri\u00eang bi\u1ec7t n\u00f3i ri\u00eang, \u0111\u00e1p \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 k\u00fd ch\u1ee7 v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng \u0111\u1ec1u \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong sinh b\u1ec7nh h\u1ecdc c\u1ee7a kh\u1ed1i u d\u1ea1 d\u00e0y. C\u00e1c ch\u1ee7ng kh\u00e1c nhau c\u1ee7a HP c\u0169ng c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh kh\u1ea3 n\u0103ng g\u00e2y ra b\u1ec7nh l\u00fd \u00e1c t\u00ednh ho\u1eb7c l\u00e0 lo\u00e9t.<\/p>\n<p>C\u00e1c ch\u1ee7ng HP s\u1ea3n xu\u1ea5t VacA v\u00e0 CagA k\u00edch th\u00edch ph\u1ea3n \u1ee9ng vi\u00eam m\u00f4 m\u1ea1nh h\u01a1n v\u00e0 k\u00edch th\u00edch s\u1ea3n xu\u1ea5t cytokine nhi\u1ec1u h\u01a1n c\u00e1c ch\u1ee7ng kh\u00f4ng \u0111\u1ed9c t\u1ed1 n\u00e0y. Hai gene kh\u00e1c (picA v\u00e0 picB, hi\u1ec7n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 CagE) \u0111\u01b0\u1ee3c c\u00f9ng phi\u00ean m\u00e3 v\u1edbi cagA. S\u1ea3n ph\u1ea9m gene c\u1ee7a picB (CagE) k\u00edch th\u00edch s\u1ef1 gi\u1ea3i ph\u00f3ng c\u1ee7a c\u00e1c cytokine bi\u1ec3u m\u00f4, bao g\u1ed3m interleukin-8 (IL-8).<\/p>\n<p>Vi khu\u1ea9n s\u1ea3n xu\u1ea5t nhi\u1ec1u ch\u1ea5t kh\u00e1ng nguy\u00ean, bao g\u1ed3m heat shock protein, urease v\u00e0 lipopolysaccharide, c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t t\u1ebf b\u00e0o T v\u00e0 k\u00edch th\u00edch ph\u1ea3n \u1ee9ng c\u1ee7a bi\u1ec3u m\u00f4, ch\u1eb3ng h\u1ea1n nh\u01b0 l\u00e0m cho t\u1ed1c \u0111\u1ed9 t\u0103ng tr\u01b0\u1edfng v\u00e0 t\u1eed vong c\u1ee7a t\u1ebf b\u00e0o bi\u1ec3u m\u00f4 d\u1ea1 d\u00e0y b\u1ecb thay \u0111\u1ed5i. Nhi\u1ec5m H. pylori c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t ph\u1ea3n \u1ee9ng c\u1ee7a c\u00e1c t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u , d\u1eabn \u0111\u1ebfn s\u1ef1 di chuy\u1ec3n c\u1ee7a c\u00e1c t\u1ebf b\u00e0o n\u00e0y \u0111\u1ebfn v\u1ecb tr\u00ed nhi\u1ec5m khu\u1ea9n v\u00e0 gi\u1ea3i ph\u00f3ng c\u00e1c ch\u1ea5t oxy h\u00f3a ph\u1ea3n \u1ee9ng, g\u00e2y h\u1ea1i cho DNA v\u00e0 d\u1eabn \u0111\u1ebfn \u0111\u1ed9t bi\u1ebfn v\u00e0 \u00e1c t\u00ednh h\u00f3a.<\/p>\n<h3>2.2 M\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng v\u1ec1 li\u00ean quan c\u1ee7a Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y<\/h3>\n<ul>\n<li>C\u00e1c nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 h\u1ecdc cho th\u1ea5y m\u1ed1i t\u01b0\u01a1ng quan m\u1ea1nh gi\u1eefa s\u1ef1 nhi\u1ec5m H. pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y. V\u00ed d\u1ee5, nghi\u00ean c\u1ee9u EUROGAST tr\u00ean 17 nh\u00f3m d\u00e2n c\u01b0 t\u1eeb 13 qu\u1ed1c gia kh\u00e1c nhau (11 qu\u1ed1c gia ch\u00e2u \u00c2u, Hoa K\u1ef3 v\u00e0 Nh\u1eadt B\u1ea3n) \u0111\u00e3 ph\u00e1t hi\u1ec7n ra nguy c\u01a1 ung th\u01b0 d\u1ea1 d\u00e0y t\u0103ng g\u1ea5p s\u00e1u l\u1ea7n \u1edf c\u00e1c nh\u00f3m nhi\u1ec5m H. pylori so v\u1edbi c\u00e1c nh\u00f3m kh\u00f4ng nhi\u1ec5m<\/li>\n<li>M\u1ed9t trong nh\u1eefng nghi\u00ean c\u1ee9u ti\u1ebfn c\u1ee9u l\u1edbn nh\u1ea5t li\u00ean quan \u0111\u1ebfn nguy c\u01a1 ung th\u01b0 v\u00e0 nhi\u1ec5m HP v\u1edbi s\u1ef1 tham gia c\u1ee7a 1526 b\u1ec7nh nh\u00e2n t\u1ea1i Nh\u1eadt B\u1ea3n, trong \u0111\u00f3 c\u00f3 1246 b\u1ec7nh nh\u00e2n nhi\u1ec5m HP. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh n\u1ed9i soi v\u00e0 l\u1ea5y m\u1eabu sinh thi\u1ebft khi \u0111\u0103ng k\u00fd tham gia v\u00e0 sau \u0111\u00f3 t\u1eeb m\u1ed9t \u0111\u1ebfn ba n\u0103m sau \u0111\u0103ng k\u00fd. Trong qu\u00e1 tr\u00ecnh theo d\u00f5i trung b\u00ecnh 7.8 n\u0103m, 36 b\u1ec7nh nh\u00e2n \u0111\u00e3 ph\u00e1t tri\u1ec3n ung th\u01b0 d\u1ea1 d\u00e0y ( chi\u1ebfm t\u1ef7 l\u1ec7 2.9%), t\u1ea5t c\u1ea3 \u0111\u1ec1u nhi\u1ec5m H. pylori. Kh\u00f4ng c\u00f3 b\u1ec7nh nh\u00e2n kh\u00f4ng nhi\u1ec5m H. pylori n\u00e0o ph\u00e1t tri\u1ec3n ung th\u01b0.<\/li>\n<li>C\u01a1 quan Nghi\u00ean c\u1ee9u Ung th\u01b0 Qu\u1ed1c t\u1ebf \u01b0\u1edbc t\u00ednh r\u1eb1ng 36% v\u00e0 47% t\u1ed5ng s\u1ed1 ung th\u01b0 d\u1ea1 d\u00e0y t\u01b0\u01a1ng \u1ee9ng \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n v\u00e0 n\u01b0\u1edbc \u0111ang ph\u00e1t tri\u1ec3n li\u00ean quan \u0111\u1ebfn nhi\u1ec5m HP. \u0110i\u1ec1u n\u00e0y \u0111\u1ea1i di\u1ec7n cho g\u1ea7n 350.000 ca ung th\u01b0 d\u1ea1 d\u00e0y h\u00e0ng n\u0103m tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.<\/li>\n<\/ul>\n<p>T\u1eeb c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean, c\u00f3 th\u1ec3 th\u1ea5y r\u1eb1ng nhi\u1ec5m Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y c\u00f3 m\u1ed1i li\u00ean h\u1ec7 v\u1edbi nhau. Nhi\u1ec5m HP l\u00e0 nguy\u00ean nh\u00e2n quan tr\u1ecdng g\u00e2y ung th\u01b0 d\u1ea1 d\u00e0y. V\u00ec v\u1eady, vi\u1ec7c ph\u00e1t hi\u1ec7n s\u1edbm nhi\u1ec5m H. pylori \u0111\u1ec3 c\u00f3 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p s\u1ebd \u0111\u00f3ng g\u00f3p quan tr\u1ecdng trong vi\u1ec7c h\u1ea1n ch\u1ebf di\u1ec5n ti\u1ebfn \u0111\u1ebfn ung th\u01b0 d\u1ea1 d\u00e0y. T\u1ea1i h\u1ec7 th\u1ed1ng B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c T\u1ebf <a href=\"https:\/\/vinmec.com\/vi\/dangkykham\/\">Vinmec<\/a>, c\u00f3 c\u00e1c c\u00f4ng ngh\u1ec7 v\u00e0 chuy\u00ean gia gi\u00fap ch\u1ea9n \u0111o\u00e1n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p cho b\u1ec7nh nh\u00e2n,<\/p>\n<p>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/p>\n<p>Uemura N, Okamoto S, Yamamoto S. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001 Sep 13;345(11):784-9.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>K\u1ec3 t\u1eeb khi \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n v\u00e0o kho\u1ea3ng th\u1eadp ni\u00ean 80 c\u1ee7a th\u1ebf k\u1ef7 XXI, ng\u00e0y c\u00e0ng c\u00f3 nhi\u1ec1u nghi\u00ean c\u1ee9u v\u1ec1 m\u1ed1i quan h\u1ec7 gi\u1eefa xo\u1eafn khu\u1ea9n Helicobacter pylori (HP) n\u00e0y v\u00e0 c\u00e1c b\u1ec7nh l\u00fd c\u1ee7a tr\u00ean c\u01a1 th\u1ec3 con ng\u01b0\u1eddi. C\u01a1 quan Nghi\u00ean c\u1ee9u Ung th\u01b0 Qu\u1ed1c t\u1ebf \u0111\u00e3 tuy\u00ean b\u1ed1 r\u1eb1ng HP [&hellip;]<\/p>\n","protected":false},"author":37,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>M\u1ed1i quan h\u1ec7 gi\u1eefa Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u1eeb c\u00e1c nghi\u00ean c\u1ee9, c\u00f3 th\u1ec3 th\u1ea5y r\u1eb1ng nhi\u1ec5m Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y c\u00f3 m\u1ed1i li\u00ean h\u1ec7 m\u1eadt thi\u1ebft v\u1edbi nhau\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"M\u1ed1i quan h\u1ec7 gi\u1eefa Helicobacter pylori v\u00e0 ung th\u01b0 d\u1ea1 d\u00e0y - 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