Giuliani Andrea, Galati Gaspare, Demoro Martino, Scimò Michele, Pecorella Irene, Basso Luigi
Department of Surgery Pietro Valdoni, University of Rome La Sapienza, Italy.
Arch Surg. 2010 Oct;145(10):962-7. doi: 10.1001/archsurg.2010.211.
Gastric cancer commonly follows a long-standing inflammation, mainly due to Helicobacter pylori (HP) infection. After resection, the stump develops precancerous alterations.
Prospective study of patients undergoing endoscopy from April 1, 2000, through March 31, 2006.
University departments of Surgery and Experimental Medicine and Pathology.
One hundred eighty-seven patients receiving upper gastrointestinal tract endoscopy many years after surgery for duodenal ulcer or gastric cancer. Ten to 12 postoperative endoscopic biopsy samples were taken from the remnant stomach.
The risk of gastric cancer precursor lesions associated with HP infection.
The gastric cancer precursor lesions were more common in the entire HP-positive population (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.25-4.49; P = .007). However, HP-positive patients undergoing resection for cancer had a higher risk of the precursor lesions compared with HP-negative patients in the same diagnostic group (OR, 4.20; 95% CI, 1.10-15.96) and all patients undergoing resection for duodenal ulcer (OR, 1.59; 95% CI, 0.44-5.73).
The results of this investigation support the role of HP in gastric carcinogenesis and suggest that the HP eradication therapy might prevent the development of metachronous gastric cancer after gastric resection.
胃癌通常继发于长期炎症，主要是由于幽门螺杆菌（HP）感染。切除术后，残端会出现癌前病变。
对2000年4月1日至2006年3月31日接受内镜检查的患者进行前瞻性研究。
大学外科、实验医学和病理学系。
187例在十二指肠溃疡或胃癌手术后多年接受上消化道内镜检查的患者。从残胃中采集10至12份术后内镜活检样本。
与HP感染相关的胃癌前病变风险。
在整个HP阳性人群中，胃癌前病变更为常见（优势比[OR]，2.37；95%置信区间[CI]，1.25 - 4.49；P = 0.007）。然而，与同一诊断组中的HP阴性患者相比，接受癌症切除术的HP阳性患者发生前体病变的风险更高（OR，4.20；95% CI，1.10 - 15.96），与所有接受十二指肠溃疡切除术的患者相比也是如此（OR，1.59；95% CI，0.44 - 5.73）。
本研究结果支持HP在胃癌发生中的作用，并表明根除HP治疗可能预防胃切除术后异时性胃癌的发生。
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