Lee Sang-Ah, Kang Daehee, Shim Ki Nam, Choe Jae Won, Hong Weon Seon, Choi Haymie
Department of Food and Nutrition, Seoul National University, Shillim-Dong, Kwanak-Gu, Korea.
J Epidemiol. 2003 May;13(3):162-8. doi: 10.2188/jea.13.162.
The association of dietary habits and Helicobacter pylori infection with early gastric cancer is still unclear.
A hospital-based case-control study was conducted in Korea. Sixty-nine patients were newly diagnosed as having early gastric cancer at the Division of Gastroenterology, Asan Medical Center, and 199 healthy subjects who visited the Health Promotion Center of the this same hospital for annual health examinations were selected as controls. Helicobacter pylori infection status was assayed by ELISA, and information for dietary habits was obtained by interview using a semi-quantitative food frequency questionnaires. Preference for salty taste was also evaluated using a sensitive test.
H. pylori seropositivity was observed in 88% of cases, as compared with 75% of controls (OR = 5.3, 95% confidence interval:1.7-16.5). Adaptive salt concentration was significantly and positively associated with early gastric cancer risk (p < 0.01). Decreased risks of early gastric cancer were observed in association with intakes of clear broth, raw vegetables, fruits, fruit or vegetable juices, and soybean curds. On the other hand, a high intake of salt-fermented fish and kimchi were associated with an elevated risk of early gastric cancer. Subjects with positive H. pylori infection and a high salty preference had a 10-fold higher risk of early gastric cancer than subjects without H. pylori infection and with a low salty preference (p for interaction = 0.047).
Some dietary factors and H. pylori infection are significantly associated with early gastric cancer. In particular, high-salty diets may enhance the effect of H. pyori infection in gastric carcinogenesis.
饮食习惯和幽门螺杆菌感染与早期胃癌之间的关联仍不明确。
在韩国开展了一项基于医院的病例对照研究。69例患者在峨山医学中心胃肠病科被新诊断为早期胃癌，199名前往同一医院健康促进中心进行年度健康检查的健康受试者被选为对照组。通过酶联免疫吸附测定法检测幽门螺杆菌感染状况，并使用半定量食物频率问卷通过访谈获取饮食习惯信息。还通过一项敏感测试评估对咸味的偏好。
88%的病例检测到幽门螺杆菌血清阳性，而对照组为75%（比值比=5.3，95%置信区间：1.7 - 16.5）。适应性盐浓度与早期胃癌风险呈显著正相关（p<0.01）。摄入清汤、生蔬菜、水果、果蔬汁和豆腐与早期胃癌风险降低有关。另一方面，高盐发酵鱼和泡菜的高摄入量与早期胃癌风险升高有关。幽门螺杆菌感染阳性且咸味偏好高的受试者患早期胃癌的风险比未感染幽门螺杆菌且咸味偏好低的受试者高10倍（交互作用p=0.047）。
一些饮食因素和幽门螺杆菌感染与早期胃癌显著相关。特别是，高盐饮食可能会增强幽门螺杆菌感染在胃癌发生过程中的作用。
