Sang-Ho Park, Napapan Kangwan, Jong-Min Park, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA Cancer Institute, CHA University, Seoul 135-081, South Korea.
World J Gastroenterol. 2013 Dec 21;19(47):8986-95. doi: 10.3748/wjg.v19.i47.8986.
Although the International Agency for Research on Cancer declared Helicobacter pylori (H. pylori) as a definite human carcinogen in 1994, the Japanese Society for Helicobacter Research only recently (February 2013) adopted the position that H. pylori infection should be considered as an indication for either amelioration of chronic gastritis or for decreasing gastric cancer mortality. Japanese researchers have found that H. pylori eradication halts progressive mucosal damage and that successful eradication in patients with non-atrophic gastritis most likely prevents subsequent development of gastric cancer. However, those who have already developed atrophic gastritis/gastric atrophy retain potential risk factors for gastric cancer. Because chronic perpetuated progression of H. pylori-associated gastric inflammation is associated with increased morbidity culminating in gastric carcinogenesis, a non-microbial approach to treatment that provides long-term control of gastric inflammation through nutrients and other interventions may be an effective way to decrease this morbidity. This non-microbial approach might represent a new form of prerequisite "rescue" therapy that provides a quicker path to the prevention of gastric cancer as compared to simple eradication.
虽然国际癌症研究机构于 1994 年宣布幽门螺杆菌(H. pylori)为明确的人类致癌物,但日本幽门螺杆菌研究学会直到最近(2013 年 2 月)才采取这一立场,即认为 H. pylori 感染应被视为改善慢性胃炎或降低胃癌死亡率的指征。日本研究人员发现,H. pylori 的根除可阻止进行性黏膜损伤,并且在非萎缩性胃炎患者中成功根除 H. pylori 极有可能预防随后发生胃癌。然而,已经患有萎缩性胃炎/胃萎缩的患者仍然存在胃癌的潜在危险因素。由于与 H. pylori 相关的胃炎症的慢性持续进展与发病率的增加有关,最终导致胃癌变,因此通过营养物质和其他干预措施提供对胃炎症的长期控制的非微生物治疗方法可能是降低这种发病率的有效方法。与单纯根除相比,这种非微生物方法可能代表一种新形式的必要“挽救”疗法,为预防胃癌提供了更快的途径。