Weck Melanie N, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
Int J Cancer. 2008 Aug 15;123(4):874-81. doi: 10.1002/ijc.23539.
Helicobacter pylori is a major risk factor for chronic atrophic gastritis (CAG). A large variety of definitions of CAG have been used in epidemiologic studies in the past. The aim of this work was to systematically review and summarize estimates of the association between H. pylori infection and CAG according to the various definitions of CAG. Articles on the association between H. pylori infection and CAG published until July 2007 were identified. Separate meta-analyses were carried out for studies defining CAG based on gastroscopy with biopsy, serum pepsinogen I (PG I) only, the pepsinogen I/pepsinogen II ratio (PG I/PG II ratio) only, or a combination of PG I and the PG I/PG II ratio. Numbers of identified studies and summary odds ratios (OR) (95% confidence intervals) were as follows: gastroscopy with biopsy: n = 34, OR = 6.4 (4.0-10.1); PG I only: n = 13, OR = 0.9 (0.7-1.2); PG I/PG II ratio: n = 8, OR = 7.2 (3.1-16.8); combination of PG I and the PG I/PG II ratio: n = 20, OR = 5.7 (4.4-7.5). Studies with CAG definitions based on gastroscopy with biopsy or the PG I/PG II ratio (alone or in combination with PG I) yield similarly strong associations of H. pylori with CAG. The association is missed entirely in studies where CAG is defined by PG I only.
幽门螺杆菌是慢性萎缩性胃炎（CAG）的主要危险因素。过去在流行病学研究中使用了各种各样的CAG定义。这项工作的目的是根据CAG的各种定义，系统回顾和总结幽门螺杆菌感染与CAG之间关联的估计值。确定了截至2007年7月发表的关于幽门螺杆菌感染与CAG之间关联的文章。对基于胃镜活检、仅血清胃蛋白酶原I（PG I）、仅胃蛋白酶原I/胃蛋白酶原II比值（PG I/PG II比值）或PG I与PG I/PG II比值组合来定义CAG的研究分别进行了荟萃分析。已确定研究的数量和汇总比值比（OR）（95%置信区间）如下：胃镜活检：n = 34，OR = 6.4（4.0 - 10.1）；仅PG I：n = 13，OR = 0.9（0.7 - 1.2）；PG I/PG II比值：n = 8，OR = 7.2（3.1 - 16.8）；PG I与PG I/PG II比值组合：n = 20，OR = 5.7（4.4 - 7.5）。基于胃镜活检或PG I/PG II比值（单独或与PG I组合）定义CAG的研究得出幽门螺杆菌与CAG之间的关联同样强烈。在仅由PG I定义CAG的研究中，这种关联完全未被发现。
