Cam Sebahat
Department of Pediatrics, Division of Pediatric Gastroenterology, Istanbul Medeniyet University Medical School, Istanbul, Turkey E-mail :
Asian Pac J Cancer Prev. 2014;15(22):9905-8. doi: 10.7314/apjcp.2014.15.22.9905.
Helicobacter pylori (H. pylori) is the most common chronic infectious agent in the stomach. Most importantly, it may lead to atrophy, metaplasia and cancer. The aim of this study was to investigate the incidence of H. pylori infection and to detect early mucosal changes that may lead to malignant degeneration in children.
Children who underwent upper gastrointestinal endoscopy were included. Familial history of gastric cancer was noted. Endoscopic examinations were performed by a single pediatric gastroenterologist. A minimum of three biopsy samples were collected during endoscopy. The patients were accepted as H. pylori infected if results of biopsies and rapid urease test were both positive. Biopsies were evaluated for the presence and degree of chronic inflammation, the activity and severity of gastritis, glandular atrophy and intestinal metaplasia.
A total of 750 children (388 boys, 362 girls) were evaluated in our study, with a mean age of 10.1 years. A total of 390 patients (52%) were found to be infected with H. pylori. Among the H. pylori infected patients, 289 (74%) were diagnosed to have chronic superficial gastritis, 24 (6.2%) had gastric atrophy. Most strikingly, intestinal metaplasia was observed in 11 children, all were in the H. pylori positive group. There was no difference in the mean of age, gender and socioeconomic class between H. pylori infected and non-infected groups. The frequency of gastric cancer in family members (4 in number) was higher in patients with H. pylori infection. No gastric cancer case was reported from the parents of non-infected children. The worst biopsy parameters (atropy and metaplasia) were improved after H. pylori eradication on control endoscopy.
The current study shows a higher prevalence of familial history of gastric cancer in H. pylori infected children. Intestinal metaplasia was also higher in the infected children. Eradication of H. pylori infection for this risk group may prevent subsequent development of gastric cancer.
幽门螺杆菌（H. pylori）是胃中最常见的慢性感染因子。最重要的是，它可能导致萎缩、化生和癌症。本研究的目的是调查儿童幽门螺杆菌感染的发生率，并检测可能导致恶性退变的早期黏膜变化。
纳入接受上消化道内镜检查的儿童。记录胃癌家族史。内镜检查由一名儿科胃肠病学家进行。内镜检查期间至少采集三个活检样本。如果活检和快速尿素酶试验结果均为阳性，则患者被视为幽门螺杆菌感染。对活检样本进行慢性炎症的存在和程度、胃炎的活动和严重程度、腺体萎缩和肠化生的评估。
本研究共评估了750名儿童（388名男孩，362名女孩），平均年龄为10.1岁。共发现390名患者（52%）感染了幽门螺杆菌。在幽门螺杆菌感染患者中，289名（74%）被诊断为慢性浅表性胃炎，24名（6.2%）有胃萎缩。最引人注目的是，在11名儿童中观察到肠化生，所有儿童均在幽门螺杆菌阳性组。幽门螺杆菌感染组和未感染组在年龄、性别和社会经济阶层的平均值上没有差异。幽门螺杆菌感染患者家庭成员中的胃癌发生率（4例）较高。未感染儿童的父母中未报告胃癌病例。在对照内镜检查中，幽门螺杆菌根除后活检参数最差的情况（萎缩和化生）有所改善。
当前研究表明，幽门螺杆菌感染儿童中胃癌家族史的患病率较高。感染儿童中的肠化生也较高。对该风险组进行幽门螺杆菌感染根除可能预防随后的胃癌发生。
