Kozu T, Saito D
Endoscopy Division, National Cancer Center Hospital, Chuo-ku, Tokyo 104-0045.
Rinsho Byori. 2001 Feb;49(2):121-5.
Since the discovery of Helicobacter pylori(H. pylori), causal linkage between H. pylori infection and some of gastric disease has been generally accepted from the results of many studies. Indeed the usefulness of H. pylori eradication therapy for acute gastritis, peptic ulcer, gastric polyp and MALT lymphoma etc. has been reported. In the low grade MALT lymphoma, the regression rate by this therapy is about 70%. On the other hand, we should pay the caution to several adverse effects, such as drug resistance and GERD, of H. pylori eradication therapy. However, based on the several results of comparative studies between antibiotic therapy and the other one, the antibiotic therapy for peptic ulcer is only covered by national health insurance at present. The reversibility of gastric precancerous conditions such as mucosal atrophy, intestinal metaplasia and dysplasia by antibiotic therapy has been studied, but its significance is not clear yet. In animal experiment, H. pylori infection induced gastric adenocarcinoma in Mongolian Gerbils. However, this phenomenon is limited to this kind of animal only. To proof the causal link between H. pylori infection and genesis of gastric cancer in human being, clinical intervention trials are ongoing in the world. If these trials can clarify it, the H. pylori eradication therapy will be established as preventive measure for gastric carcinogenesis.
自从发现幽门螺杆菌（H. pylori）以来，许多研究结果已使幽门螺杆菌感染与某些胃部疾病之间的因果联系得到普遍认可。事实上，已有报道称幽门螺杆菌根除疗法对急性胃炎、消化性溃疡、胃息肉和黏膜相关淋巴组织淋巴瘤等疾病有效。在低级别黏膜相关淋巴组织淋巴瘤中，该疗法的缓解率约为70%。另一方面，我们应该注意幽门螺杆菌根除疗法的一些不良反应，如耐药性和胃食管反流病（GERD）。然而，根据抗生素疗法与其他疗法的多项比较研究结果，目前国家健康保险仅涵盖消化性溃疡的抗生素治疗。抗生素疗法对胃黏膜萎缩、肠化生和发育异常等胃癌前期病变的可逆性进行了研究，但其意义尚不清楚。在动物实验中，幽门螺杆菌感染在蒙古沙鼠中诱发了胃腺癌。然而，这种现象仅局限于这类动物。为了证明幽门螺杆菌感染与人类胃癌发生之间的因果联系，世界各地正在进行临床干预试验。如果这些试验能够阐明这一点，幽门螺杆菌根除疗法将被确立为胃癌发生的预防措施。
