Hansson L E
Department of Surgery, Mora Hospital, S-792 85 Mora, Sweden.
World J Surg. 2000 Mar;24(3):315-20. doi: 10.1007/s002689910050.
The relation between peptic ulcer and stomach cancer has long been disputed, but there is accumulating evidence that gastric ulcer disease is positively associated and duodenal ulcerations negatively associated with the risk of developing stomach cancer. As Helicobacter pylori infection is associated with both types of ulceration and stomach cancer, the varying outcomes of the infection indicate that factors other than the infection must be of importance. At present, there is no convincing evidence that pharmacologic inhibition of acid secretion for treatment of peptic ulcer increases the risk of stomach cancer. However, some recent studies indicate that prolonged treatment with proton pump inhibitors may accelerate the development of atrophic gastritis, a risk factor for stomach cancer, in individuals infected with H. pylori. It has repeatedly been shown that there is an at least twofold increased risk of stomach cancer 15 years after gastric resection for peptic ulcer disease, and that the risk increases with the passage of time. Whether vagotomy has the same risk-increasing effect is still unclear.
消化性溃疡与胃癌之间的关系长期以来一直存在争议，但越来越多的证据表明，胃溃疡疾病与患胃癌风险呈正相关，而十二指肠溃疡与患胃癌风险呈负相关。由于幽门螺杆菌感染与这两种溃疡以及胃癌均有关联，该感染产生的不同结果表明，除感染之外的其他因素必定也很重要。目前，尚无令人信服的证据表明，用于治疗消化性溃疡的酸分泌药物抑制会增加患胃癌的风险。然而，一些近期研究表明，对于感染幽门螺杆菌的个体，长期使用质子泵抑制剂进行治疗可能会加速萎缩性胃炎（胃癌的一个风险因素）的发展。反复有研究表明，因消化性溃疡疾病接受胃切除术后15年患胃癌的风险至少会增加两倍，且风险会随着时间推移而增加。迷走神经切断术是否具有同样的风险增加效应仍不清楚。
