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当前位置：国际临床研究杂志 > 2026年 10卷 (8)期

Open Access Article

International Journal of Clinical Research. 2026; 10: (8) ; 41-47 ; DOI: 10.12208/j.ijcr.20260380.

Research progress on helicobacter pylori-negative gastric diseases: an emerging clinical challenge
幽门螺杆菌阴性胃相关疾病的研究进展

作者： 万晨雨¹ *, 刘崇梅²

1湖南师范大学附属岳阳医院内科学湖南岳阳

2湖南师范大学附属岳阳医院病理科湖南岳阳

*通讯作者：万晨雨,单位：湖南师范大学附属岳阳医院内科学湖南岳阳；

发布时间: 2026-08-07 总浏览量: 45

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摘要

本文通过检索PubMed、CNKI等数据库中2019-2025年包含幽门螺杆菌阴性胃相关疾病信息的已发表文章，系统梳理幽门螺杆菌阴性胃炎、胃溃疡及胃癌的流行病学、诊断、治疗与预后特征。结果显示：随着全球幽门螺杆菌根除治疗普及，幽门螺杆菌阴性胃病占比持续上升，尤其是在胃溃疡及部分早期胃癌中；幽门螺杆菌阴性胃癌具有独特临床病理特征，患者发病年龄更低、肿瘤好发于胃上部，常见胃底腺型腺癌与印戒细胞癌，伴APC、GNAS、CDH1等特异性分子改变；诊断需结合多模态检测排除幽门螺杆菌感染，辅以放大内镜与病理表型分析；治疗层面，胃溃疡以去除诱因、强化抑酸为核心，胃炎强调个体化分层管理，早期胃癌首选内镜切除，重度萎缩、异型增生及特发性溃疡患者需长期随访。本研究为幽门螺杆菌阴性胃相关疾病的规范化诊疗提供了循证参考。

关键词： 幽门螺杆菌阴性；胃炎；胃溃疡；胃癌；治疗策略

Abstract

This study systematically reviewed published articles related to Helicobacter pylori(Hp)-negative gastric diseases indexed in databases including PubMed and CNKI from 2019 to 2025, aiming to summarize the epidemiological, diagnostic, therapeutic, and prognostic features of Hp-negative gastritis, gastric ulcers, and gastric cancer. The results indicate that with the global popularization of Hp eradication therapy, the proportion of Hp-negative cases is continuously rising, particularly among patients with gastric ulcers and a subset of early gastric cancers. Hp-negative gastric cancer exhibits distinct clinicopathological characteristics: patients are generally younger at onset, tumors predominantly localize to the upper third of the stomach, and histopathological subtypes frequently include gastric adenocarcinoma of the fundic gland type and signet-ring cell carcinoma, accompanied by specific molecular alterations involving APC, GNAS, and CDH1 genes. Diagnosis requires stringent multimodal testing to exclude Hp infection, supplemented by magnifying endoscopy and pathological phenotype analysis. Regarding treatment, management of gastric ulcers centers on eliminating triggering factors and intensive acid suppression; gastritis necessitates individualized, stratified management; and early gastric cancer is primarily treated with endoscopic resection. Long-term follow-up is strongly recommended for patients presenting with severe atrophy, dysplasia, or idiopathic ulcers. This study provides evidence-based references for the standardized diagnosis and management of Hp-negative gastric diseases.

Key words： Helicobacter pylori-negative; Gastritis; Gastric ulcers; Gastric cancer; Therapeutic strategies

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引用本文

万晨雨, 刘崇梅, 幽门螺杆菌阴性胃相关疾病的研究进展[J]. 国际临床研究杂志, 2026; 10: (8) : 41-47.

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