Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Fukuoka City, Japan.
Am J Epidemiol. 2012 Mar 15;175(6):504-10. doi: 10.1093/aje/kwr345. Epub 2012 Feb 24.
The authors examined the association between white blood cell (WBC) count and the development of gastric cancer in a 19-year follow-up study of 2,558 Japanese subjects aged ≥40 years (1988-2007). The subjects were stratified into 4 groups according to baseline WBC quartile (≤4.4, 4.5-5.2, 5.3-6.3, or ≥6.4 × 10(3) cells/μL). During follow-up, 128 subjects developed gastric cancer. The age- and sex-adjusted incidence of gastric cancer increased linearly with higher WBC level: 1.7, 2.6, 3.9, and 5.4 per 1,000 person-years, respectively, for the 4 quartile groups (P for trend < 0.01). The risk of gastric cancer was 2.22-fold (95% confidence interval: 1.19, 4.14) higher in the highest WBC quartile group than in the lowest group after adjustment for confounding factors. With respect to Helicobacter pylori infection status, H. pylori-seropositive subjects in the highest WBC quartile group showed a significantly greater risk of gastric cancer than those in the lower 3 quartile groups, whereas such an association was not observed in H. pylori-seronegative subjects. There was no evidence of heterogeneity in the association (P for heterogeneity = 0.65). The study findings suggest that higher WBC levels are a risk factor for gastric cancer, especially in subjects with H. pylori infection.
作者在一项对 2558 名≥40 岁的日本受试者（1988-2007 年）进行的 19 年随访研究中，研究了白细胞（WBC）计数与胃癌发展之间的关系。根据基线 WBC 四分位（≤4.4、4.5-5.2、5.3-6.3 或≥6.4×10^3 个细胞/μL），将受试者分为 4 组。在随访期间，128 名受试者患上了胃癌。年龄和性别调整后的胃癌发病率随 WBC 水平升高呈线性增加：4 个四分位组分别为 1.7、2.6、3.9 和 5.4/1000 人年（趋势 P<0.01）。在调整混杂因素后，最高 WBC 四分位组的胃癌风险是最低四分位组的 2.22 倍（95%置信区间：1.19，4.14）。对于幽门螺杆菌感染状态，在最高 WBC 四分位组的 H. pylori 血清阳性受试者中，胃癌的风险明显高于较低的 3 个四分位组，而在 H. pylori 血清阴性受试者中则没有观察到这种关联。这种关联没有异质性（异质性 P=0.65）。研究结果表明，较高的 WBC 水平是胃癌的危险因素，尤其是在 H. pylori 感染的受试者中。
