Wang Run-Tian, Wang Tao, Chen Kun, Wang Ji-Yao, Zhang Jie-Ping, Lin San-Ren, Zhu Yi-Min, Zhang Wen-Ming, Cao Yu-Xin, Zhu Chou-Wen, Yu Hai, Cong Yu-Jun, Zheng Shu, Wu Bing-Quan
Health Science Center, Peking University, Beijing, China.
World J Gastroenterol. 2002 Dec;8(6):1103-7. doi: 10.3748/wjg.v8.i6.1103.
To explore the association between Helicobacter pylori (Hp) infection and risk of gastric cancer in China.
Utilizing gastroendoscopic biospsy tissue banks accumulated from 1980 to 1988 in Shandong, Zhejiang, and Jiangsu, where stomach cancer incidence was high, during stomach cancer screening conducted by Health Science Center of Peking University, School of Medicine of Zhejiang University, and Zhongshan Hospital of Fudan University. Warthin Starry silver staining method was applied to determine H. pylori infection status of biopsies collected during gastroendoscopic examination. In the retrospective study, the subjects were divided into two cohorts, the exposure cohort was positive H. pylori infection, and the non-exposure cohort was negative. Death from stomach cancer was determined as the outcome of the study. Logistic regression and Cox regression were applied to analyze the association between Helicobacter pylori infection and gastric cancer risk. In the nested case-control study, there were 28 deaths from gastric cancer in the fields of Muping, Shandong province, and Zhoushan, Zhejiang provinces. 4 controls were matched to each case on the basis of age (+/-5 years old), sex, residential place at the same time entered into the study. Conditional logistic regression analysis was used to analyze the data.
There were a total of 2 719 subjects (male 1 399, female 1 320) with gastroendoscopic biopsies stored available treated as a cohort. H. pylori positive cohort included 1 671 subjects (61.5 %) and H. pylori negative cohort 1 048 subjects(38.5 %). These subjects were followed up for 1-19 years, averaged 10.88 years. The outcome of death from stomach cancer in the exposure cohort was 33, and in the non-exposure cohort 11. After adjustment for age and sex, RR=1.9850 (P=0.0491), 95 % CI was 1.0026, and 3.9301. The results of conditional logistic regression showed an OR of 4.467 and 95 % CI of 1.161, and 17.190 for the nested case control study.
The results from the retrospective cohort study and the nested-case control study on the association of H. pylori infection and gastric cancer in China suggested that Helicobacter pylori infection might increase the risk of stomach cancer.
探讨中国幽门螺杆菌（Hp）感染与胃癌风险之间的关联。
利用北京大学医学部、浙江大学医学院和复旦大学附属中山医院在胃癌高发地区山东、浙江和江苏于1980年至1988年积累的胃镜活检组织库，在胃癌筛查期间进行研究。采用Warthin Starry银染色法确定胃镜检查时采集的活检组织的Hp感染状况。在回顾性研究中，将受试者分为两个队列，暴露队列是Hp感染阳性，非暴露队列是Hp感染阴性。将胃癌死亡作为研究结局。应用Logistic回归和Cox回归分析Hp感染与胃癌风险之间的关联。在巢式病例对照研究中，山东省牟平区和浙江省舟山市有28例胃癌死亡病例。按照年龄（±5岁）、性别、居住地相同的原则，为每个病例匹配4名对照，同时纳入研究。采用条件Logistic回归分析数据。
共有2719名接受胃镜活检的受试者（男性1399名，女性1320名）可作为一个队列进行研究。Hp阳性队列包括1671名受试者（61.5%），Hp阴性队列1048名受试者（38.5%）。这些受试者随访1至19年，平均10.88年。暴露队列中胃癌死亡结局为33例，非暴露队列中为11例。调整年龄和性别后，RR = 1.9850（P = 0.0491），95%CI为1.0026至3.9301。条件Logistic回归结果显示，巢式病例对照研究的OR为4.467，95%CI为1.161至17.190。
关于中国Hp感染与胃癌关联的回顾性队列研究和巢式病例对照研究结果表明，Hp感染可能增加胃癌风险。
