Rugge M, Busatto G, Cassaro M, Shiao Y H, Russo V, Leandro G, Avellini C, Fabiano A, Sidoni A, Covacci A
Department of Oncologic and Surgical Sciences, University of Padova and ULSS, Italy.
Cancer. 1999 Jun 15;85(12):2506-11.
In the general population, Helicobacter pylori (H. pylori), particularly the cagA positive strain, has been associated with intestinal-type gastric carcinoma. Gastric carcinomas are rarely observed in patients age < or = 40 years. Host-related factors have been thought to be more important than environmental agents in these early-onset cancers. The aim of this study was to ascertain the possible role of H. pylori infection and that of cagA positive strains in the development of gastric carcinoma in these young patients.
In this case-control study, 105 gastric carcinoma patients (male-to-female ratio = 1.1; mean age, 34.4 years; range, 16-40 years) and an equal number of controls (matched for gender and age) were retrospectively selected from the same geographic area. The phenotypes of gastritis and H. pylori were histologically assessed, and the presence of the ureC gene, which is indicative of H. pylori infection, and the cagA genotype were determined by polymerase chain reaction. Gastric carcinoma risk was calculated by both univariate and multivariate statistical methods, taking into account the cancer phenotype, the gastritis phenotype detected in both patients and controls, and the H. pylori genotype.
For 74 diffuse and 31 intestinal gastric carcinomas, multivariate logistic regression analysis produced results consistent with those of univariate statistical tests, showing a significant association between gastric carcinoma and both H. pylori infection (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.52-5.11) and cagA positive status (OR = 2.94; 95% CI = 1.56-5.52).
In young Italian patients with gastric carcinoma, the significant association with cagA positive H. pylori infection suggests that the bacterium has an etiologic role in both diffuse-type and intestinal-type gastric carcinoma.
在普通人群中，幽门螺杆菌（H. pylori），尤其是cagA阳性菌株，与肠型胃癌有关。胃癌在年龄≤40岁的患者中很少见。在这些早发性癌症中，宿主相关因素被认为比环境因素更重要。本研究的目的是确定幽门螺杆菌感染以及cagA阳性菌株在这些年轻患者胃癌发生中的可能作用。
在这项病例对照研究中，从同一地理区域回顾性选取了105例胃癌患者（男女比例为1.1；平均年龄34.4岁；范围16 - 40岁）以及同等数量的对照（按性别和年龄匹配）。通过组织学评估胃炎和幽门螺杆菌的表型，并通过聚合酶链反应确定指示幽门螺杆菌感染的ureC基因的存在以及cagA基因型。考虑到癌症表型、患者和对照中检测到的胃炎表型以及幽门螺杆菌基因型，采用单变量和多变量统计方法计算胃癌风险。
对于74例弥漫性和31例肠型胃癌，多变量逻辑回归分析结果与单变量统计测试结果一致，显示胃癌与幽门螺杆菌感染（优势比[OR]=2.79；95%置信区间[CI]=1.52 - 5.11）和cagA阳性状态（OR = 2.94；95% CI = 1.56 - 5.52）均存在显著关联。
在年轻的意大利胃癌患者中，与cagA阳性幽门螺杆菌感染的显著关联表明该细菌在弥漫型和肠型胃癌中均具有病因学作用。
