Department of Gastrointestinal Endoscopy, Tama-Nagayama University Hospital of Nippon Medical School, 1-7-1 Nagayama, Tama-city, Tokyo, 206-8512, Japan.
Helicobacter. 2012 Oct;17(5):396-401. doi: 10.1111/j.1523-5378.2012.00967.x. Epub 2012 Jul 2.
The prevalence of Helicobacter pylori (H. pylori) infection is high, but the incidence of gastric cancer is low in natives of Bangladesh. The gastric mucosa was observed in Bangladeshi patients to investigate the differences between Bangladeshis and Japanese.
The study involved 418 Bangladeshi and 2356 Japanese patients with abdominal complaints who underwent endoscopy examinations and had no history of H. pylori eradication. The prevalence of H. pylori infection and the gastric mucosa in H. pylori-positive patients were compared between age-, gender-, and endoscopic diagnosis-matched Bangladeshi and Japanese subjects.
The prevalence of H. pylori infection was higher in Bangladeshi than in Japanese subjects (60.2 and 45.1%, respectively). All the scores for chronic inflammation, neutrophil activity, glandular atrophy, and intestinal metaplasia were significantly lower in H. pylori-positive Bangladeshis than in H. pylori-positive Japanese. The ratio of the corpus gastritis score (C) to the antrum gastritis score (A) (C/A ratio) was <1 (antrum-predominant gastritis) in all age groups of Bangladeshi subjects, whereas the C/A ratio changed from <1 to more than 1 (corpus-predominant gastritis) with aging in Japanese subjects.
The scores for glandular atrophy and intestinal metaplasia in H. pylori-positive Bangladeshis were significantly lower than those in Japanese. All age groups of Bangladeshis had antrum-predominant gastritis, whereas corpus-predominant gastritis was more common than antrum-predominant gastritis in older Japanese age groups. These results may explain the low incidence of gastric cancer in Bangladeshis and the high incidence in Japanese.
在孟加拉国人中，幽门螺杆菌（H. pylori）感染的流行率很高，但胃癌的发病率却很低。为了研究孟加拉人与日本人之间的差异，对孟加拉国患者的胃黏膜进行了观察。
本研究纳入了 418 名有腹部不适症状的孟加拉国患者和 2356 名日本患者，这些患者均接受了内镜检查且无 H. pylori 根除史。比较了年龄、性别和内镜诊断匹配的孟加拉国和日本患者中 H. pylori 感染的流行率以及 H. pylori 阳性患者的胃黏膜情况。
孟加拉国患者 H. pylori 感染的流行率高于日本患者（分别为 60.2%和 45.1%）。H. pylori 阳性的孟加拉国患者的慢性炎症、中性粒细胞活性、腺体萎缩和肠化生评分均显著低于 H. pylori 阳性的日本患者。所有年龄组的孟加拉国患者的胃体胃炎评分（C）与胃窦胃炎评分（A）比值（C/A 比值）均<1（胃窦炎为主），而日本患者的 C/A 比值随年龄增长从<1变为>1（以胃体炎为主）。
H. pylori 阳性的孟加拉国患者的腺体萎缩和肠化生评分显著低于日本患者。所有年龄组的孟加拉国患者均为胃窦炎为主，而年龄较大的日本患者中以胃体炎为主的比例高于胃窦炎为主。这些结果可能解释了孟加拉国胃癌发病率低而日本发病率高的原因。
