Nieminen Anna A, Kontto Jukka, Puolakkainen Pauli, Virtamo Jarmo, Kokkola Arto
a Department of Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
b Department of Public Health Solutions , National Institute for Health and Welfare (THL) , Helsinki , Finland.
Scand J Gastroenterol. 2019 Feb;54(2):145-151. doi: 10.1080/00365521.2019.1566492. Epub 2019 Jan 31.
The aim of this study was to evaluate long-term gastric cancer risk in male smokers with and without atrophic gastritis.
A total of 22,346 elderly male smokers participated in the Helsinki Gastritis Study between the years 1989 and 1993. Serum pepsinogen I (PGI) was measured for the men, and 2,132 men with low PGI (<25 µg/L; a marker of atrophic corpus gastritis) were invited to undergo gastroscopy because of increased gastric cancer risk. Endoscopy was performed to 1,327 men, who were followed up for a median of 13.6 years and a maximum of 25.3 years thereafter. In addition, the gastric cancer risk of men with low PGI was compared to that of the men with normal PGI and to the general Finnish male population of the same age.
Thirty-five cases of gastric cancer were diagnosed in men with gastroscopy during the follow-up. The incidence rate was 1.94 per 1000 patient years. The men with a history of gastric surgery (n = 180) due to a benign cause had even higher gastric cancer incidence (3.2 per 1000 patient-years). Gastric cancer risk was highest in men with marked intestinal metaplasia in primary biopsies. Compared to the general Finnish male population of the same age, the cancer risk was 1.13 times higher in male smokers with normal serum PGI, and 2.43 times higher in men with low serum PGI.
In male smokers, atrophic gastritis and intestinal metaplasia increase the risk of gastric cancer.
本研究旨在评估有和没有萎缩性胃炎的男性吸烟者患胃癌的长期风险。
1989年至1993年间，共有22346名老年男性吸烟者参与了赫尔辛基胃炎研究。对这些男性测量了血清胃蛋白酶原I（PGI），2132名PGI水平低（<25μg/L；萎缩性胃体炎的标志物）的男性因患胃癌风险增加而被邀请接受胃镜检查。对1327名男性进行了内镜检查，随后对他们进行了中位时间为13.6年、最长25.3年的随访。此外，将PGI水平低的男性患胃癌的风险与PGI水平正常的男性以及同龄的芬兰男性总体人群的风险进行了比较。
随访期间，接受胃镜检查的男性中有35例被诊断为胃癌。发病率为每1000患者年1.94例。因良性原因有胃手术史（n = 180）的男性胃癌发病率甚至更高（每1000患者年3.2例）。初次活检时有明显肠化生的男性患胃癌的风险最高。与同龄的芬兰男性总体人群相比，血清PGI正常的男性吸烟者患癌风险高1.13倍，血清PGI低的男性患癌风险高2.43倍。
在男性吸烟者中，萎缩性胃炎和肠化生会增加患胃癌的风险。
