Perbandingan Kadar VEGF (Vascular Endothelial Growth Factor) Serum Antara Status CagA+ (Cytotoxin-Associated Gene A Positive) dan CagA- (Cytotoxin-Associated Gene A Negative) pada Pasien Gastritis H.Pylori

Abstract

Latar belakang:Helicobacter pylori (H.pylori) merupakan agen penyebab terjadinya gastritis dan ulkus gaster,yang pada akhirnya menyebabkan terjadinya tumor gaster.Prevalensinya rata-rata 80 % di negara berkembang dan 20-50 % di negara maju. Salah satu faktor virulensinya yaitu CagA(Cytotoxin-associated gene A) berperan dalam peningkatan inflamasi, proliferasi sel dan metaplasia mukosa gaster. VEGF, merupakan faktor angiogenik yang berperan dalam proses pembentukan jaringan mukosa baru setelah proses inflamasi oleh H.pylori. Peningkatan ekspresi VEGF berkontribusi terhadap proses awal terjadinya karsinogenesis gaster. Tujuan Penelitian: Mengetahui perbandingan kadar serum VEGF pada status CagA (+) dan CagA(-) pada penderita gastritis H.pylori. Metode:Penelitian dilakukan dengan desain cross sectional terhadap 30 pasien gastritis H.pylorisetelah menjalani tindakan gastroskopi,biopsi danpemeriksaan CLO test,dilanjutkan dengan pemeriksaan kadar serum VEGF dengan metoda ELISA serta CagA dengan metode PCR. Data dianalisis dengan SPSS versi 22. Perbedaan signifikan bila p < 0,05. Hasil: Dari 30 subyek penelitian yang sudah dianalisis secara statistik, 18 orang ( 60 % ) pria, 12 orang perempuan (46%), median umur 53,5 tahun (20-68), mayoritas bersuku batak 16 orang (53,3%), penderita gastritis H. pylori dengan CagA(+) sebanyak 21 orang (70%) dan penderita gastritis H. pylori dengan CagA(-) sebanyak 9 orang (30%). Didapatkan median kadar serum VEGF 480,3 pg/dl (115,5-2185,2) pada gastritis H.pylori dengan CagA (+) (p=0,005) signifikan lebih tinggi dibandingkan gastritis H.Pylori dengan CagA (-) dengan kadar serum VEGF 291,1 pg/dl (158,4-556,7). Kesimpulan: Dijumpai peningkatan kadar serum VEGF secara signifikan lebih tinggi pada penderita gastritis H.pylori positif CagA (+) dibandingkan dengan H.pylori positif CagA (-)

Background:Helicobacter pylori (H.pylori) is an agent that causes gastritis and the ulcer of gaster, which can lead to make the gastric tumor at the end. The prevalence is about 80 % average in developing country and 20-50 % indeveloped countries. One of the virulence factor isCagA (Cytotoxin-associated gene A) that plays a role in inflammation process,cell proliferation and metaplasia in gastric mucosa. VEGF, is one of angiogenic factor that plays a role in process of making new mucosal tissue after the inflammation of the H.pylori. The escalation of VEGF expression levels contribute for the beginning of gastric carcinogenesis. Objective: To identify the ratio of VEGF serum levels between CagA (+) and CagA (-) in patients with H.pylorigastritis. Methods:Cross sectional study was conducted towards30 patients withH.pylori gastritis after they have done gastroscopy,biopsy and CLO test, which were continued with VEGF serum examination with ELISA test and perfomed PCR test to get CagA.Then analyzed the data with SPSS 22 version,with p< 0.05was significant. Result:30 subjects, 18 men (60 %), 12 women (46%), with median age average was 53.5 years old.Majority ethnic was batak with 16 subjects (53.3%).H.pylori gastritis with CagA(+) was about 21 subjects (70%) and H.pylori gastritis with CagA(-) was about 9 subjects (30%). We found median serum levels of VEGF about 480.3 pg/dl (115.5-2185.2) in patients of H.pylori gastritis with CagA(+) morehigher then H.pylori gastritis with CagA(-) with median serum levels of VEGF 291.1 pg/dl(158.4-556.7) and it was significant (p=0.005). Conclusion: It was found median serum levels of VEGF more higher significant in patients of H.pylori gastritis with CagA(+) thenH.pylori gastritis with CagA (-)