Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.
GI and Liver Center, Bangkok Medical Center, Bangkok, Thailand.
J Med Microbiol. 2013 Oct;62(Pt 10):1571-1578. doi: 10.1099/jmm.0.060905-0. Epub 2013 Jul 5.
Gastric cancer is the second leading cause of cancer-related mortality in the world. Recently, serum Helicobacter pylori antibodies and pepsinogen (PG) have been used for gastric cancer screening. The incidence of gastric cancer in Bhutan is reported to be quite high compared with that in neighbouring countries. In this study, 381 subjects from three areas of Bhutan were assessed for gastric mucosal atrophy and serological parameters. Anti-H. pylori IgG, PG I, PG II and cytotoxin-associated gene A (CagA) antibodies were measured using ELISA. Subjects were classified into four groups according to H. pylori and PG seropositivity: Group A (H. pylori-negative/PG-negative), Group B (H. pylori-positive/PG-negative), Group C (H. pylori-positive/PG-positive) and Group D (H. pylori-negative/PG-positive). The prevalence of H. pylori in the 381 subjects was 71.1% (271/381), with high infection rates found in rural areas. The PG I/II ratio was significantly inversely correlated with the atrophy score in the antrum and the corpus (P<0.001). Multivariate analysis showed that the PG status was significantly associated with the presence of atrophy in the corpus. The prevalence of the PG-positive status was significantly higher among H. pylori-positive subjects than among H. pylori-negative subjects (P<0.001). Based on the ABC method, Group B was the most dominant, followed by Group A, Group C and Group D. The high incidence of gastric cancer in Bhutan can be attributed to the high prevalence of H. pylori infection and gastric mucosal atrophy.
胃癌是全球癌症相关死亡的第二大主要原因。最近，血清幽门螺杆菌抗体和胃蛋白酶原（PG）已被用于胃癌筛查。与邻国相比，不丹的胃癌发病率据报道相当高。在这项研究中，对不丹三个地区的 381 名受试者进行了胃黏膜萎缩和血清学参数评估。使用 ELISA 测量抗幽门螺杆菌 IgG、PG I、PG II 和细胞毒素相关基因 A（CagA）抗体。根据 H. pylori 和 PG 血清阳性情况，将受试者分为四组：A 组（H. pylori 阴性/PG 阴性）、B 组（H. pylori 阳性/PG 阴性）、C 组（H. pylori 阳性/PG 阳性）和 D 组（H. pylori 阴性/PG 阳性）。381 名受试者中 H. pylori 的患病率为 71.1%（271/381），农村地区的感染率较高。PG I/II 比值与胃窦和胃体的萎缩评分呈显著负相关（P<0.001）。多变量分析显示，PG 状态与胃体萎缩的存在显著相关。H. pylori 阳性受试者的 PG 阳性状态患病率显著高于 H. pylori 阴性受试者（P<0.001）。根据 ABC 法，B 组最为常见，其次是 A 组、C 组和 D 组。不丹胃癌发病率高的原因可能是 H. pylori 感染和胃黏膜萎缩的高患病率。
