Vilaichone Ratha-korn, Panarat Wirat, Aekpongpaisit Surasak, Mahachai Voracha
GI Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand E-mail :
Asian Pac J Cancer Prev. 2014;15(20):9005-8. doi: 10.7314/apjcp.2014.15.20.9005.
Gastric cancer is the second leading course of cancer death worldwide and H. pylori infection is an important risk factor for gastric cancer development. This study was design to evaluate the clinical, pathological features, survival rate and prevalence of H. pylori infection in gastric cancer in Thailand.
Clinical information, histological features, endoscopic findings and H. pylori status were collected from gastric cancer patients from Thammasat university hospital during June 1996-December 2011. H. pylori infection was assessed by histological evaluation, rapid urease test and serological test. Clinical information, endoscopic findings and histopathology of all patients were recorded and compared between patients with active or non-active H. pylori infection.
A total of 100 gastric cancer patients (55 men and 45 women with mean age of 55±16.8 years) were enrolled in this study. Common presenting symptoms were dyspepsia (74%), weight loss (66%), anemia (63%) and anorexia (38%). Mean duration of symptoms prior to diagnosis was 98 days. Overall prevalence of H. pylori infection was 83% and active H. pylori infection was 40%. 1-year and 5-year survival rates were 43% and 0%. There was no significant difference between active H. pylori infection in different locations (proximal vs non-proximal: 47.1% vs 48.5%; P-value=0.9, OR=0.9; 95%CI=0.3-3.1) and histology of gastric cancer (diffuse type vs intestinal type: 47.4% vs 50%; P-value=0.8, OR=0.9, 95%CI=0.3-2.7). However, linitis plastica was significantly more common in non-active than active H. pylori infection (27.9% vs 0%; P-value<0.0001, OR=13.3, 95%CI=3.2-64.5). Moreover, gastric cancer stage 4 was higher in non-active than active H. pylori infection (93% vs 50%, P-value<0.001).
Prevalence of H. pylori infection in Thai gastric cancer patients was high but active infection was low. Most gastric cancer patients presented in advance stage and had a grave prognosis. Screening for gastric cancer in high risk individuals might be an appropriate tool for early detection and improve the treatment outcome for this particular disease in Thailand.
胃癌是全球癌症死亡的第二大主要原因，幽门螺杆菌感染是胃癌发生的重要危险因素。本研究旨在评估泰国胃癌患者的临床、病理特征、生存率及幽门螺杆菌感染率。
收集1996年6月至2011年12月期间泰国法政大学医院胃癌患者的临床信息、组织学特征、内镜检查结果及幽门螺杆菌感染状况。通过组织学评估、快速尿素酶试验和血清学试验评估幽门螺杆菌感染情况。记录所有患者的临床信息、内镜检查结果及组织病理学情况，并对幽门螺杆菌感染活跃或不活跃的患者进行比较。
本研究共纳入100例胃癌患者（55例男性和45例女性，平均年龄55±16.8岁）。常见症状为消化不良（74%）、体重减轻（66%）、贫血（63%）和厌食（38%）。诊断前症状的平均持续时间为98天。幽门螺杆菌感染的总体患病率为83%，活跃感染率为40%。1年和5年生存率分别为43%和0%。不同部位（近端与非近端：47.1%对48.5%；P值=0.9，OR=0.9；95%CI=0.3 - 3.1）及胃癌组织学类型（弥漫型与肠型：47.4%对50%；P值=0.8，OR=0.9，95%CI=0.3 - 2.7）的幽门螺杆菌活跃感染情况无显著差异。然而，皮革胃在幽门螺杆菌非活跃感染患者中比活跃感染患者更常见（27.9%对0%；P值<0.0001，OR=13.3，95%CI=3.2 - 64.5）。此外，幽门螺杆菌非活跃感染患者的胃癌4期比例高于活跃感染患者（93%对50%，P值<0.001）。
泰国胃癌患者中幽门螺杆菌感染率高，但活跃感染率低。大多数胃癌患者就诊时已处于晚期，预后严重。对高危个体进行胃癌筛查可能是泰国早期发现并改善这种特定疾病治疗效果的合适工具。
