Scheiman J M, Cutler A F
Division of Gastroenterology, The University of Michigan Medical Center, Ann Arbor 48109-0362, USA.
Am J Med. 1999 Feb;106(2):222-6. doi: 10.1016/s0002-9343(98)00393-3.
Infection with Helicobacter pylori is now recognized as the primary cause of peptic ulcers and their recurrence. Compelling evidence has also been found linking H. pylori infection to gastric cancer, the second most common cancer in the world. Given the high rate of patient morbidity and mortality associated with gastric cancer, any method by which one can reduce the occurrence of the disease or increase its early detection is desirable. The strong correlation with H. pylori infection and the current availability of easily administered tests for the detection of the pathogen argue for screening at least those individuals with a family history of gastric cancer or other risk factors. This article reviews the association between H. pylori and gastric cancer and the pathologic changes that the infection produces in the gastric mucosa, as well as the cost-effectiveness of universal testing and eradication of the infection in H. pylori-positive individuals to reduce gastric cancer.
幽门螺杆菌感染现已被确认为消化性溃疡及其复发的主要原因。也已发现有力证据表明幽门螺杆菌感染与胃癌有关，胃癌是全球第二大常见癌症。鉴于胃癌相关的患者发病率和死亡率很高，任何能够降低该疾病发生率或提高其早期检测率的方法都是可取的。幽门螺杆菌感染与胃癌之间的强相关性以及目前可用于检测该病原体的易于实施的检测方法，支持至少对那些有胃癌家族史或其他风险因素的个体进行筛查。本文综述了幽门螺杆菌与胃癌之间的关联、该感染在胃黏膜中产生的病理变化，以及对幽门螺杆菌阳性个体进行普遍检测和根除感染以降低胃癌发生的成本效益。
