Chen Xin-Zu, Schöttker Ben, Castro Felipe Andres, Chen Hongda, Zhang Yan, Holleczek Bernd, Brenner Hermann
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Oncotarget. 2016 Mar 29;7(13):17182-93. doi: 10.18632/oncotarget.7946.
To assess the association of H. pylori and chronic atrophic gastritis (AG) with colonic, pancreatic and gastric cancer in a population-based prospective cohort.
Serum antibodies against H. pylori in general and specific to cytotoxin-associated gene A (CagA), as well as serum pepsinogen I and II were analyzed in 9,506 men and women, aged 50-75 years in a cohort study from Saarland, Germany. Incident cases of colonic, pancreatic and gastric cancer were ascertained by record linkage with data from the Saarland Cancer Registry.
During an average follow-up of 10.6 years, 108 colonic, 46 pancreatic and 27 gastric incident cancers were recorded. There was no association between H. pylori infection and colonic cancer (HR = 1.07; 95% CI 0.73-1.56) or pancreatic cancer (HR = 1.32; 0.73-2.39), regardless of either CagA seropositivity or AG status. In contrast, CagA+ infection was associated with a strongly increased risk of gastric cancer, especially non-cardia gastric cancer, and this association was particularly pronounced in the presence of AG. Compared to people without AG and without CagA+ infection, people with both risk factors had a significantly increased risk of non-cardia gastric cancer (HR = 32.4; 7.6-137.6).
This large cohort study did not observe an association of H. pylori infection or AG with colonic or pancreatic cancer, but underlines that the vast majority of non-cardia gastric cancers arise from AG and infection with CagA+ H. pylori strains.
在一项基于人群的前瞻性队列研究中，评估幽门螺杆菌（H. pylori）和慢性萎缩性胃炎（AG）与结肠癌、胰腺癌和胃癌之间的关联。
在德国萨尔州的一项队列研究中，对9506名年龄在50 - 75岁的男性和女性，分析了抗幽门螺杆菌的总体血清抗体以及针对细胞毒素相关基因A（CagA）的特异性血清抗体，同时分析了血清胃蛋白酶原I和II。通过与萨尔州癌症登记处的数据进行记录链接，确定结肠癌、胰腺癌和胃癌的发病病例。
在平均10.6年的随访期间，记录了108例结肠癌、46例胰腺癌和27例胃癌发病病例。无论CagA血清阳性或AG状态如何，幽门螺杆菌感染与结肠癌（风险比[HR]=1.07；95%置信区间[CI] 0.73 - 1.56）或胰腺癌（HR = 1.32；0.73 - 2.39）之间均无关联。相比之下，CagA +感染与胃癌风险显著增加相关，尤其是非贲门胃癌，并且在存在AG的情况下这种关联尤为明显。与无AG且无CagA +感染的人相比，同时具有这两种风险因素的人患非贲门胃癌的风险显著增加（HR = 32.4；7.6 - 137.6）。
这项大型队列研究未观察到幽门螺杆菌感染或AG与结肠癌或胰腺癌之间存在关联，但强调绝大多数非贲门胃癌源于AG以及感染CagA +幽门螺杆菌菌株。
