Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Dig Dis Sci. 2012 Oct;57(10):2687-92. doi: 10.1007/s10620-012-2095-6. Epub 2012 Apr 7.
Obesity is one of the main risk factors for gastric cardia adenocarcinoma (GCA) in the West. Also, recent studies have suggested that GCA is distinct from distal stomach tumor, with differing risk factors, tumor characteristics, and biological behavior. The objective of our research was to evaluate the relationship between obesity and GCA compared to non-cardia adenocarcinoma.
A total of 298 patients who were diagnosed with gastric adenocarcinoma and underwent surgery at Seoul National University Bundang Hospital were evaluated. Ninety-one cases were GCA, and 207 cases were non-cardiac adenocarcinoma. Obesity was estimated by body mass index (BMI, kg/m(2)). The degree of obesity was determined by using BMI <18.5, 18.5-23.9, 24-27.9, and ≥ 28 (kg/m(2)) as the cut-off points for underweight, normal weight, overweight, and obese, respectively. Association with obesity was estimated by odds ratio (OR) and 95% confidence interval (CI).
Obesity was more prevalent in patients with GCA at the time of diagnosis for gastric cancer. Among obese persons with a BMI of 28 kg/m(2) or higher, the OR was 3.937 (95% CI, 1.492-10.389; p = 0.006) for GCA compared to non-cardia adenocarcinoma. For overweight individuals, the OR was 2.194 (95% CI, 1.118-4.305; p = 0.022). Multivariate analysis of age, Helicobacter pylori infection, smoking, stage, and BMI with logistic regression was performed. BMI was an independent risk factor for GCA (OR, 1.123; 95% CI, 1.037-1.217; p = 0.004).
Obesity was more prevalent in patients with GCA compared to that in patients with gastric non-cardia adenocarcinoma. Also, BMI was an independent risk factor for GCA.
肥胖是西方胃贲门腺癌（GCA）的主要危险因素之一。此外，最近的研究表明，GCA 与远端胃肿瘤不同，具有不同的危险因素、肿瘤特征和生物学行为。我们研究的目的是评估肥胖与 GCA 之间的关系，并与非贲门腺癌进行比较。
评估了在首尔国立大学盆唐医院接受手术的 298 例胃腺癌患者。91 例为 GCA，207 例为非贲门腺癌。采用体重指数（BMI，kg/m²）来评估肥胖。通过 BMI <18.5、18.5-23.9、24-27.9 和 ≥28（kg/m²）将肥胖程度分为消瘦、正常体重、超重和肥胖。通过比值比（OR）和 95%置信区间（CI）来评估与肥胖的关联。
在诊断为胃癌时，GCA 患者的肥胖更为普遍。在 BMI 为 28kg/m²或更高的肥胖人群中，GCA 的 OR 为 3.937（95%CI，1.492-10.389；p=0.006），而非贲门腺癌的 OR 为 2.194（95%CI，1.118-4.305；p=0.022）。采用逻辑回归对年龄、幽门螺杆菌感染、吸烟、分期和 BMI 进行多元分析。BMI 是 GCA 的独立危险因素（OR，1.123；95%CI，1.037-1.217；p=0.004）。
与非贲门腺癌患者相比，GCA 患者更普遍存在肥胖。此外，BMI 是 GCA 的独立危险因素。
