Miftahussurur Muhammad, Sharma Rabi Prakash, Shrestha Pradeep Krishna, Maharjan Ramesh Kumar, Shiota Seiji, Uchida Tomohisa, Sato Hiroki, Yamaoka Yoshio
Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan E-mail :
Asian Pac J Cancer Prev. 2015;16(17):7911-6. doi: 10.7314/apjcp.2015.16.17.7911.
Serum anti-Helicobacter pylori antibodies and pepsinogens (PGs) have been used as gastric cancer screening and gastric mucosal status markers. Nepal is a low risk country for gastric cancer. However, the mountainous populace in the northern region culturally linked to Tibet as well as Bhutan, a neighboring country, have a high risk of GC. We collected gastric biopsy specimens and sera from 146 dyspeptic patients living in Kathmandu, Nepal. We also examined the sera of 80 volunteers living in the mountainous regions of the Himalayas. The optimal cut-off was calculated for serum biomarkers against the histology. Kathmandu patients (43.8%) were serologically positive for H. pylori infection, which was significantly lower than that for the mountainous (61.3%, P = 0.01). The same results also found in the prevalence of PG-positivity, PG I levels and PG I/II ratios (P = 0.001, P <0.0001 and P = 0.03, respectively). Moreover, the PG I/II ratios were significantly, and inversely correlated with the OLGA score (r = -0.33, P <0.009). The low incidence of gastric cancer in Nepal can be attributed to low gastric mucosal atrophy. However, the mountainous subjects have high-risk gastric mucosal status, which could be considered a high-risk population in Nepal.
血清抗幽门螺杆菌抗体和胃蛋白酶原（PGs）已被用作胃癌筛查和胃黏膜状态标志物。尼泊尔是胃癌低风险国家。然而，与西藏以及邻国不丹在文化上有联系的北部山区民众患胃癌风险较高。我们收集了尼泊尔加德满都146名消化不良患者的胃活检标本和血清。我们还检测了80名生活在喜马拉雅山区志愿者的血清。针对组织学情况计算了血清生物标志物的最佳临界值。加德满都患者幽门螺杆菌感染血清学阳性率为43.8%，显著低于山区患者（61.3%，P = 0.01）。PG阳性率、PG I水平和PG I/II比值的患病率也有相同结果（分别为P = 0.001、P <0.0001和P = 0.03）。此外，PG I/II比值与OLGA评分显著负相关（r = -0.33，P <0.009）。尼泊尔胃癌发病率低可归因于胃黏膜萎缩程度低。然而，山区人群胃黏膜状态处于高风险，可被视为尼泊尔的高风险人群。
