Elzouki Abdel-Naser Y, Buhjab Soad I, Alkialani Akram, Habel Salah, Sasco Annie J
Department of Medicine, Hamad General Hospital, HMC, Doha, Qatar.
Arab J Gastroenterol. 2012 Jun;13(2):85-8. doi: 10.1016/j.ajg.2012.06.002. Epub 2012 Jul 11.
The aim of this study was to determine the pattern of histologically-proven gastric cancer in Eastern Libya and explore its association with Helicobacter pylori infection.
The registries of the Departments of Histopathology, Faculty of Medicine, Benghazi University and Oncology, Al-Jomhoria Hospital, Benghazi, were reviewed for cases with primary gastrointestinal cancer from January 2000 to December 2002 (sole Histopathology and Oncology Departments in Eastern Libya). Slides of hematoxylin and eosin stain of gastric cancer patients were re-stained to detect H. pylori. The American Joint Committee on Cancer Tumor, Node, Metastasis staging was used for clinical and pathologic staging. Gastric cancer biopsy materials were classified into intestinal or diffuse type according to Lauren criteria.
One hundred and fourteen cases of gastric cancer were diagnosed. Tumor stages were: 2 (14%), 3 (21%), 4 (57%) and unknown (8%). Most common site of involvement was the antrum (48%). Diffuse adenocarcinoma occurred in 56 patients (49.1%), intestinal adenocarcinoma in 46 (40.4%) and malignant gastric lymphoma in 12 (10.5%). The overall frequency of H. pylori infection was 63.2% (72/114), more frequent in intestinal adenocarcinoma (71.7%) and malignant lymphoma (66.6%) than diffuse adenocarcinoma (55.3%). The frequency of gastric cancer increased throughout the three years of study.
The majority of the patients were diagnosed in locally advanced or metastatic stage. Clearly more efforts need to be given to early detection. We showed a stronger association of H. pylori infection with intestinal type gastric adenocarcinoma and malignant lymphoma than diffuse adenocarcinoma suggesting that H. pylori infection is the most probable causal factor of gastric cancer in this part of Libya.
本研究旨在确定利比亚东部经组织学证实的胃癌模式，并探讨其与幽门螺杆菌感染的关联。
回顾了班加西大学医学院组织病理学系以及班加西人民医院肿瘤学系的登记资料，以获取2000年1月至2002年12月期间原发性胃肠道癌的病例（利比亚东部仅有的组织病理学和肿瘤学系）。对胃癌患者苏木精和伊红染色的切片进行重新染色以检测幽门螺杆菌。采用美国癌症联合委员会肿瘤、淋巴结、转移分期系统进行临床和病理分期。根据劳伦标准将胃癌活检材料分为肠型或弥漫型。
共诊断出114例胃癌病例。肿瘤分期为：2期（14%）、3期（21%）、4期（57%）和分期不明（8%）。最常受累部位是胃窦（48%）。弥漫性腺癌56例（49.1%），肠腺癌46例（40.4%），恶性胃淋巴瘤12例（10.5%）。幽门螺杆菌感染的总体发生率为63.2%（72/114），在肠腺癌（71.7%）和恶性淋巴瘤（66.6%）中比弥漫性腺癌（55.3%）更常见。在研究的三年中，胃癌的发生率呈上升趋势。
大多数患者在局部晚期或转移期被诊断出来。显然需要加大早期检测的力度。我们发现幽门螺杆菌感染与肠型胃腺癌和恶性淋巴瘤的关联比与弥漫性腺癌的关联更强，这表明幽门螺杆菌感染是利比亚这一地区胃癌最可能的致病因素。
