Kato I, Tominaga S, Ito Y, Kobayashi S, Yoshii Y, Matsuura A, Kameya A, Kano T, Ikari A
Division of Epidemiology, Aichi Cancer Center Hospital, Nagoya.
Jpn J Cancer Res. 1992 Nov;83(11):1137-42. doi: 10.1111/j.1349-7006.1992.tb02736.x.
The relation of atrophic gastritis, other gastric lesions and lifestyle factors to stomach cancer risk was prospectively studied among 3,914 subjects who underwent gastroscopic examination and responded to a questionnaire survey at the Aichi Cancer Center Hospital. During 4.4 years of follow-up on average, 45 incident cases of stomach cancer were identified at least three months after the initial examination. If the baseline endoscopic findings indicated the presence of atrophic gastritis, the risk of developing stomach cancer was increased 5.73-fold, compared with no indication at the baseline. The risk further increased with advancing degree of atrophy and increasing extension of atrophy on the lesser curvature. These trends in the relative risks were statistically significant (P = 0.027 and P = 0.041, respectively). The risk of developing stomach cancer was statistically significantly increased among subjects with gastric polyps, but not among those with gastric ulcer. Stomach cancer cases tended to consume more cigarettes, alcohol, rice, pickles and salted fish gut/cod roe and less fruits and vegetables and to have more family histories of stomach cancer than noncases, although these differences were not statistically significant. The results of the present study provide additional evidence on the relation between atrophic gastritis and stomach cancer and suggest a need for intensive follow-up of patients with atrophic gastritis and gastric polyps.
在爱知县癌症中心医院，对3914名接受胃镜检查并回复问卷调查的受试者进行了前瞻性研究，以探讨萎缩性胃炎、其他胃部病变及生活方式因素与胃癌风险之间的关系。在平均4.4年的随访期间，在初次检查至少三个月后确诊了45例新发胃癌病例。如果基线内镜检查结果显示存在萎缩性胃炎，与基线无此表现相比，患胃癌的风险增加了5.73倍。随着萎缩程度的加重和胃小弯侧萎缩范围的扩大，风险进一步增加。这些相对风险的趋势具有统计学意义（分别为P = 0.027和P = 0.041）。胃癌风险在胃息肉患者中统计学显著增加，但在胃溃疡患者中未增加。与非病例相比，胃癌病例往往吸烟、饮酒、食用大米、泡菜和咸鱼肠/鳕鱼籽更多，食用水果和蔬菜更少，且有胃癌家族史的比例更高，尽管这些差异无统计学意义。本研究结果为萎缩性胃炎与胃癌之间的关系提供了更多证据，并提示需要对萎缩性胃炎和胃息肉患者进行密切随访。
