Kato I, Tominaga S, Ito Y, Kobayashi S, Yoshii Y, Matsuura A, Kameya A, Kano T
Division of Epidemiology, Nagoya.
Jpn J Cancer Res. 1992 Oct;83(10):1041-6. doi: 10.1111/j.1349-7006.1992.tb02719.x.
The relationship between atrophic gastritis and stomach cancer risk was investigated in case-control analyses involving 387 cases with stomach cancer and 5,422 control subjects who received gastroscopic examination at Aichi Cancer Center Hospital from April, 1985 to March, 1989. The presence of atrophic gastritis, the degree and extension of the atrophy and the presence of granularity and erosion were diagnosed endoscopically by six gastroenterologists. The prevalence of atrophic gastritis increased with age and was higher in males than in females. The relative risk (RR) of stomach cancer was 5.13 (95% confidence interval (CI): 2.79-9.42) if a subject had any type of atrophic gastritis. The risk further increased with advancing degree of atrophy and increasing extension on the greater and lesser curvatures. The RR associated with severe atrophy was 7.73 (95% CI: 3.95-15.12). These associations remained significant when analyzed by sex and age. The presence of granularity and erosion did not much affect the estimated risks. A clear difference in risk appeared in the analyses by histological type of cancer. The RR associated with atrophic gastritis was 24.71 (95% CI: 3.46-176.68) for the intestinal type and 3.49 (95% CI: 1.77-6.87) for the diffuse type. These findings may suggest a need for intensive follow-up of patients with severe atrophic gastritis.
在1985年4月至1989年3月期间于爱知县癌症中心医院接受胃镜检查的387例胃癌病例和5422例对照受试者中进行了病例对照分析，以研究萎缩性胃炎与胃癌风险之间的关系。由六位胃肠病学家通过内镜诊断萎缩性胃炎的存在、萎缩的程度和范围以及颗粒状和糜烂的存在情况。萎缩性胃炎的患病率随年龄增长而增加，男性高于女性。如果受试者患有任何类型的萎缩性胃炎，胃癌的相对风险（RR）为5.13（95%置信区间（CI）：2.79 - 9.42）。随着萎缩程度的加重以及大、小弯处范围的扩大，风险进一步增加。与严重萎缩相关的RR为7.73（95% CI：3.95 - 15.12）。按性别和年龄分析时，这些关联仍然显著。颗粒状和糜烂的存在对估计风险影响不大。在按癌症组织学类型进行的分析中出现了明显的风险差异。与萎缩性胃炎相关的RR在肠型为24.71（95% CI：3.46 - 176.68），在弥漫型为3.49（95% CI：1.77 - 6.87）。这些发现可能表明需要对严重萎缩性胃炎患者进行密切随访。
