Murakami Kazunari, Kodama Masaaki, Sato Ryugo, Okimoto Tadayoshi, Watanabe Koichiro, Fujioka Toshio
Department of Gastroenterology, Oita University, Faculty of Medicine, 1-1 Hasama, Oita 879-5593, Japan.
Expert Rev Anti Infect Ther. 2005 Oct;3(5):757-64. doi: 10.1586/14787210.3.5.757.
Persistent Helicobacter pylori infection contributes towards the development of chronic gastritis. To clarify the changes in chronic gastritis as a precursor of gastric cancer secondary to H. pylori eradication is an important issue, as it has significant implications for reducing the risk of gastric cancer. Studies published to date, however, are far from consistent with regard to the morphologic changes reported following H. pylori eradication. Of these, some papers reported improvement in gastric atrophy or intestinal metaplasia, versus others reporting no improvement, with the majority of papers published after 2000 reporting improvement in these end points. The inconsistent results concerning the impact of H. pylori eradication on gastric atrophy could be due to the inconsistency of the diagnostic criteria employed for evaluation of the morphology, confounded by the difficulties involved in evaluating atrophic changes in the gastric mucosa. While adherence to the Updated Sydney System available for evaluation of gastritis is primarily required worldwide to ensure consistency in evaluating gastritis, long-term research into the morphologic changes associated with H. pylori eradication is also required to explore strategies for the prevention of gastric cancer with H. pylori eradication.
幽门螺杆菌持续感染会导致慢性胃炎的发生。阐明作为根除幽门螺杆菌后继发胃癌的前驱病变——慢性胃炎的变化是一个重要问题，因为这对降低胃癌风险具有重要意义。然而，迄今为止发表的研究在报道根除幽门螺杆菌后所出现的形态学变化方面远未达成一致。其中，一些论文报道胃萎缩或肠化生有所改善，而另一些则报道无改善，2000年以后发表的大多数论文报道这些终点指标有所改善。关于根除幽门螺杆菌对胃萎缩的影响结果不一致，可能是由于评估形态学所采用的诊断标准不一致，同时也因评估胃黏膜萎缩性变化存在困难而受到干扰。虽然全球主要要求遵循可用于评估胃炎的更新悉尼系统以确保评估胃炎的一致性，但还需要对与根除幽门螺杆菌相关的形态学变化进行长期研究，以探索通过根除幽门螺杆菌预防胃癌的策略。
