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幽门螺杆菌感染与癌前病变及胃癌的关联:扬中县的一项病例对照研究

Association of Helicobacter pylori infection with precancerous lesions and stomach cancer: a case-control study in Yangzhong County.

作者信息

Shi Y, Li J, Li M, Wang L, Guo W, Qin D, Geng C, Forman D, Newell D G, Peto R, Blot W J

机构信息

Department of Epidemiology, Cancer Institute, CAMS & PUMC, Beijing 100021.

出版信息

Chin Med Sci J. 1997 Sep;12(3):175-80.

Abstract

Previous study has raised H. pylori infection as a suspected biologic risk factor for gastric cancer. A comparative case-control study involving precancerous lesions and gastric cancer was conducted in Yanzhong county, an area with one of the highest rates of gastric cancer in China to study the relationship between the H. pylori infection and gastric cancer. Subjects in the study were all randomly selected participants of a screening program for gastric cancer sponsored by the Cancer Institute of CAMS in cooperation with Yangzhong county Hospital. Totally, 125 normal controls, 108 superficial gastritis, 111 atrophic gastritis and 110 gastric cancer patients were included in our study according to endoscopy and pathology result. Status of H. pylori infection was evaluated by measuring IgG antibody in plasma with ELISA assay. Our result showed Odds ratios of H. pylori infection were higher among gastritis and cancer groups, 4.5 (95% CI 2.5-7.9) for superficial gastritis, 6.3 (95% CI 3.4-12) for atrophic gastritis, 3.3 (95% CI 1.9-5.9) for gastric cancer. It was found in our study that consumption of pickled vegetables and drinking dirty water increased the relative risk of H. pylori infection for both precancerous lesions and gastric cancer and that H. pylori infection had higher risk of atrophic gastritis and gastric cancer for males and also higher risk of atrophic gastritis for olders. Our results strongly support the casual role played by H. pylori infection in the carcinogenic process of gastric mucosa.

摘要

以往的研究已将幽门螺杆菌感染列为胃癌可能的生物学危险因素。在中国胃癌发病率最高的地区之一——扬中县,开展了一项涉及癌前病变和胃癌的病例对照研究,以探讨幽门螺杆菌感染与胃癌之间的关系。该研究的受试者均为中国医学科学院肿瘤研究所与扬中县医院合作开展的胃癌筛查项目的随机参与者。根据内镜检查和病理结果,本研究共纳入125名正常对照者、108名浅表性胃炎患者、111名萎缩性胃炎患者和110名胃癌患者。采用酶联免疫吸附测定法检测血浆中IgG抗体,评估幽门螺杆菌感染状况。我们的研究结果显示,胃炎组和癌症组中幽门螺杆菌感染的比值比更高,浅表性胃炎为4.5(95%可信区间2.5 - 7.9),萎缩性胃炎为6.3(95%可信区间3.4 - 12),胃癌为3.3(95%可信区间1.9 - 5.9)。我们的研究发现,食用腌制蔬菜和饮用脏水会增加癌前病变和胃癌患者幽门螺杆菌感染的相对风险,而且幽门螺杆菌感染在男性中导致萎缩性胃炎和胃癌的风险更高,在老年人中导致萎缩性胃炎的风险也更高。我们的研究结果有力地支持了幽门螺杆菌感染在胃黏膜致癌过程中所起的因果作用。

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