高胃泌素血症与远端结肠腺瘤风险增加有关。

Hypergastrinemia is associated with increased risk of distal colon adenomas.

作者信息

Georgopoulos Sotirios D, Polymeros Dimitrios, Triantafyllou Konstantinos, Spiliadi Charis, Mentis Andreas, Karamanolis Dimitrios G, Ladas Spiros D

机构信息

Gastroenterology Unit, Evangelismos Hospital, Medical School, University of Athens, Athens, Greece.

出版信息

Digestion. 2006;74(1):42-6. doi: 10.1159/000096593. Epub 2006 Oct 26.

DOI:10.1159/000096593

PMID:17068397

Abstract

BACKGROUND/AIMS: Helicobacter pylori infection is a recognized cause of hypergastrinemia, but the association of blood gastrin levels with colonic adenomas (CAs) is controversial. The aim of this study is to investigate if hypergastrinemia, H. pylori infection and/or cagA protein are risk factors for CAs.

METHODS

In this prospective case-control study, fasting serum samples from 78 consecutive patients with CAs and 78 demographically matched colonoscopy-negative controls were assayed for anti-H. pylori immunoglobulin G, cagA protein and serum gastrin levels. Multivariate analysis was performed to identify risk factors for colon adenomas.

RESULTS

Though prevalence of H. pylori antibodies was not significantly different, the prevalence of cagA protein was significantly higher in patients with adenomas (42.3%) as compared with controls (25.6%, p < 0.03). Mediangastrin levels were significantly higher in patients with CAs (55, 20-975 pg/ml) than in controls (45.2, 23-529 pg/ml) (p < 0.001). Hypergastrinemia (>110 pg/ml) was commoner in patients with CAs than in controls (29.5 vs. 11.5%, p = 0.006) and was the only independent risk factor for adenomas (odds ratio 3.2, 95% CI 1.4-7.5) by multivariate analysis, but not H. pylori infection or cagA positivity. There was a significant association of hypergastrinemia and distal distribution of adenomas (p < 0.002).

CONCLUSIONS

Our study shows that hypergastrinemia is a risk factor for CAs, especially of the distal colon.

摘要

背景/目的：幽门螺杆菌感染是公认的高胃泌素血症病因，但血胃泌素水平与结肠腺瘤（CA）之间的关联存在争议。本研究旨在调查高胃泌素血症、幽门螺杆菌感染和/或cagA蛋白是否为结肠腺瘤的危险因素。

方法

在这项前瞻性病例对照研究中，对78例连续的结肠腺瘤患者和78例人口统计学匹配的结肠镜检查阴性对照者的空腹血清样本进行抗幽门螺杆菌免疫球蛋白G、cagA蛋白和血清胃泌素水平检测。进行多变量分析以确定结肠腺瘤的危险因素。

结果

尽管幽门螺杆菌抗体的患病率无显著差异，但腺瘤患者中cagA蛋白的患病率（42.3%）显著高于对照组（25.6%，p<0.03）。结肠腺瘤患者的胃泌素水平中位数（55，20 - 975 pg/ml）显著高于对照组（45.2，23 - 529 pg/ml）（p<0.001）。高胃泌素血症（>110 pg/ml）在结肠腺瘤患者中比对照组更常见（29.5%对11.5%，p = 0.006），并且通过多变量分析是腺瘤的唯一独立危险因素（比值比3.2，95%置信区间1.4 - 7.5），而非幽门螺杆菌感染或cagA阳性。高胃泌素血症与腺瘤的远端分布存在显著关联（p<0.002）。