Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
Int J Epidemiol. 2017 Jun 1;46(3):914-923. doi: 10.1093/ije/dyx030.
Gastrin, which induces gastric acid secretion, and a structurally similar hormone, cholecystokinin (CCK)-a potent acid inhibitor, may each play a role in gastric cancer. However, few studies have investigated this hypothesis in humans. We therefore investigated whether serum gastrin or CCK concentrations at baseline were associated with the incidence of gastric non-cardia adenocarcinomas (GNCA), oesophagogastric junctional adenocarcinomas (EGJA) or gastric carcinoid tumours over 24 years of follow-up in a study nested within the all-male Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of Finnish smokers.
Totals of 283 incident GNCA, 96 EGJA and 10 gastric carcinoid cases, and 778 matched controls, were included in our analysis. Gastrin and CCK were measured using specific radioimmunoassays. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by multivariable logistic regression with adjustment for all known or suspected confounding factors, including Helicobacter pylori seropositivity.
Those with high gastrin (Q4 vs Q1), had an increased risk of GNCA (fully adjusted OR: 1.92; 95% CI: 1.21, 3.05) and gastric carcinoids, though the small number of carcinoid cases meant the fully adjusted model was unstable (age-adjusted continuous model OR: 4.67; 95% CI: 2.67, 8.15). CCK was associated with risk of GNCA only for those in Q3 relative to Q1 (OR: 0.56; 95% CI: 0.33, 0.96), and no significant trend was observed.
Our data suggest that high serum concentrations of gastrin may be associated independently with an increased risk of gastric cancer; the role of CCK in cancer risk is less clear.
胃泌素可刺激胃酸分泌，而结构相似的胆囊收缩素（CCK）是一种强大的胃酸抑制剂，两者都可能在胃癌中发挥作用。然而，很少有研究在人类中对此假说进行研究。因此，我们研究了在芬兰吸烟者的α-生育酚、β-胡萝卜素癌症预防（ATBC）研究中嵌套的一项研究中，基线时的血清胃泌素或 CCK 浓度是否与 24 年的随访中胃非贲门腺癌（GNCA）、食管胃交界处腺癌（EGJA）或胃类癌肿瘤的发生率相关。
共纳入 283 例新发 GNCA、96 例 EGJA 和 10 例胃类癌病例，以及 778 例匹配对照，我们的分析包括这些病例和对照。使用特定的放射免疫测定法测量胃泌素和 CCK。使用多变量逻辑回归估计比值比（OR）和 95%置信区间（95%CI），并调整所有已知或可疑的混杂因素，包括幽门螺杆菌血清阳性。
高胃泌素（Q4 与 Q1）组 GNCA（完全调整后的 OR：1.92；95%CI：1.21，3.05）和胃类癌的风险增加，尽管类癌病例数较少，使得完全调整后的模型不稳定（年龄调整连续模型 OR：4.67；95%CI：2.67，8.15）。CCK 仅与 Q3 组相对于 Q1 组的 GNCA 风险相关（OR：0.56；95%CI：0.33，0.96），且未观察到显著趋势。
我们的数据表明，高血清胃泌素浓度可能与胃癌风险增加独立相关；CCK 在癌症风险中的作用尚不清楚。
