Fujimori Shunji, Kishida Teruyuki, Kobayashi Tsuyoshi, Sekita Yoshihisa, Seo Tsuguhiko, Nagata Kazuhiro, Tatsuguchi Atsushi, Gudis Katya, Yokoi Kimiyoshi, Tanaka Noritake, Yamashita Kiyohiko, Tajiri Takashi, Ohaki Yoshiharu, Sakamoto Choitsu
Third Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
J Gastroenterol. 2005 Sep;40(9):887-93. doi: 10.1007/s00535-005-1649-1.
Recent reports suggest that Helicobacter pylori infection can potentially increase the risk of colorectal cancer. The purpose of this study was to assess the association between H. pylori infection and the risk of colorectal adenoma and adenocarcinoma, and to evaluate any differences on the basis of sex.
The subjects were 669 (40- to 80-year-old) patients who underwent both barium enema examination and total colonoscopy, and who were evaluated for H. pylori infection by (13)C-urea breath test, urease test, or histological diagnosis of biopsied gastric specimens. There were 142 H. pylori-negative and 527-positive patients. The odds ratios (ORs) for H. pylori-positive patients with colorectal adenoma and adenocarcinoma, and for tumor patients with either adenoma or adenocarcinoma were calculated.
Among the H. pylori-negative patients, there were 52 patients without tumor, 63 with adenoma, 27 with adenocarcinoma, and 90 with tumor. Among the H. pylori-positive patients, there were 136, 264, 127, and 391 patients respectively. Pooling all subjects, those infected with H. pylori had a significantly increased OR for adenoma, adenocarcinoma, or tumor, compared to H. pylori-free patients (OR, 1.60, 1.80, and 1.66, respectively). For female H. pylori-positive subjects, the risk of having adenocarcinoma or tumor was significantly higher than that for their H. pylori-free counterparts, while for male H. pylori-positive and -negative subjects, there was no such significant difference.
The results therefore suggest that, in patients aged 40-80 years, H. pylori infection increased the risk of colorectal adenoma and adenocarcinoma, with significantly higher risks for female patients.
最近的报告表明，幽门螺杆菌感染可能会增加患结直肠癌的风险。本研究的目的是评估幽门螺杆菌感染与结直肠腺瘤和腺癌风险之间的关联，并根据性别评估任何差异。
研究对象为669名年龄在40至80岁之间的患者，这些患者均接受了钡灌肠检查和全结肠镜检查，并通过¹³C尿素呼气试验、尿素酶试验或胃活检标本的组织学诊断来评估幽门螺杆菌感染情况。其中有142名幽门螺杆菌阴性患者和527名阳性患者。计算了幽门螺杆菌阳性患者患结直肠腺瘤和腺癌的比值比（OR），以及患腺瘤或腺癌的肿瘤患者的比值比。
在幽门螺杆菌阴性患者中，无肿瘤患者52例，腺瘤患者63例，腺癌患者27例，肿瘤患者90例。在幽门螺杆菌阳性患者中，相应的患者数分别为136例、264例、127例和391例。将所有受试者合并分析，与未感染幽门螺杆菌的患者相比，感染幽门螺杆菌的患者患腺瘤、腺癌或肿瘤的OR显著升高（分别为1.60、1.80和1.66）。对于幽门螺杆菌阳性的女性受试者，患腺癌或肿瘤的风险显著高于未感染幽门螺杆菌的女性，而对于幽门螺杆菌阳性和阴性的男性受试者，没有这种显著差异。
因此，结果表明，在40至80岁的患者中，幽门螺杆菌感染增加了结直肠腺瘤和腺癌的风险，女性患者的风险显著更高。
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