Graham David Y
Department of Medicine, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas.
Gastroenterology. 2015 Apr;148(4):719-31.e3. doi: 10.1053/j.gastro.2015.01.040. Epub 2015 Feb 2.
Helicobacter pylori infection contributes to the development of diverse gastric and extragastric diseases. The infection is necessary but not sufficient for the development of gastric adenocarcinoma. Its eradication would eliminate a major worldwide cause of cancer death, therefore there is much interest in identifying how, if, and when this can be accomplished. There are several mechanisms by which H pylori contributes to the development of gastric cancer. Gastric adenocarcinoma is one of many cancers associated with inflammation, which is induced by H pylori infection, yet the bacteria also cause genetic and epigenetic changes that lead to genetic instability in gastric epithelial cells. H pylori eradication reduces both. However, many factors must be considered in determining whether treating this bacterial infection will prevent cancer or only reduce its risk-these must be considered in designing reliable and effective eradication therapies. Furthermore, H pylori infection has been proposed to provide some benefits, such as reducing the risks of obesity or childhood asthma. When tested, these hypotheses have not been confirmed and are therefore most likely false.
幽门螺杆菌感染会促使多种胃部和胃外疾病的发生。这种感染是胃腺癌发生的必要条件，但并非充分条件。根除幽门螺杆菌将消除全球范围内癌症死亡的一个主要原因，因此人们对确定如何、是否以及何时能够实现这一目标非常感兴趣。幽门螺杆菌促使胃癌发生有多种机制。胃腺癌是与炎症相关的众多癌症之一，炎症由幽门螺杆菌感染诱发，然而这种细菌还会引起遗传和表观遗传变化，导致胃上皮细胞出现基因不稳定。根除幽门螺杆菌可降低这两者的发生率。但是，在确定治疗这种细菌感染是否会预防癌症或只是降低其风险时，必须考虑许多因素——在设计可靠且有效的根除疗法时必须考虑这些因素。此外，有人提出幽门螺杆菌感染有一些益处，比如降低肥胖或儿童哮喘的风险。经测试，这些假设未得到证实，因此很可能是错误的。
