Offerhaus G J, Tersmette A C, Tersmette K W, Tytgat G N, Hoedemaeker P J, Vandenbroucke J P
Department of Pathology, University Hospital of Leiden, The Netherlands.
Mod Pathol. 1988 Sep;1(5):352-6.
Based upon literature data, a 2-fold risk for gastric and colorectal cancer and a 2- to 5-fold risk for pancreatic cancer are predicted after remote peptic ulcer surgery. The association between previous ulcer surgery and subsequent gastric cancer appears firm; the linkage between colorectal and pancreatic cancer is more tenuous. Increased formation of carcinogens in the hypochlorhydric stomach following gastric surgery may be incriminated. Other conditions have features in common with the operated stomach and are also thought to be a suitable microenvironment for the subsequent development of cancers. Viewed in that light, further research of the putative relationship between peptic ulcer surgery and carcinogenesis and their underlying mechanism is highly desirable. Molecular cancer epidemiology and environmental pathology are proposed as useful tools for such studies. In the long run, the hypochlorhydric stomach might be a condition suitable for the chemoprevention of cancer.
根据文献数据，预计在远端消化性溃疡手术后，患胃癌和结直肠癌的风险会增加两倍，患胰腺癌的风险会增加两到五倍。既往溃疡手术与随后发生的胃癌之间的关联似乎很明确；结直肠癌和胰腺癌之间的联系则较为薄弱。胃手术后胃酸过少的胃中致癌物形成增加可能是罪魁祸首。其他情况与接受手术的胃有共同特征，也被认为是随后癌症发生的适宜微环境。从这个角度来看，非常有必要进一步研究消化性溃疡手术与致癌作用之间的假定关系及其潜在机制。分子癌症流行病学和环境病理学被认为是此类研究的有用工具。从长远来看，胃酸过少的胃可能是适合进行癌症化学预防的一种情况。
