Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan.
Genome Analysis Center, Yamanashi Central Hospital, Yamanashi, Japan.
BMC Gastroenterol. 2019 Nov 8;19(1):178. doi: 10.1186/s12876-019-1094-x.
Studies indicate that gastric cancer (GC) incidence has decreased, whereas signet ring cell carcinoma (SRC) incidence has increased. However, recent trends in GC incidence are unclear. We used our hospital cancer registry to evaluate the changes in the incidence of GC, SRC, and non-SRC (NSRC) over time in comparison to changes in the H. pylori infection rates over time.
We identified 2532 patients with GC enrolled in our registry between January 2007 and December 2018 and statistically analyzed SRC and NSRC incidence. The H. pylori infection rate in patients with SRC was determined by serum anti-H. pylori antibody testing, urea breath test, biopsy specimen culture, and immunohistochemical analysis (IHC) of gastric tissue. Additionally, genomic detection of H. pylori was performed in SRCs by extracting DNA from formalin-fixed paraffin-embedded gastric tissue and targeting 16S ribosomal RNA of H. pylori.
Overall, 211 patients had SRC (8.3%). Compared with patients with NSRC, those with SRC were younger (P < 0.001) and more likely to be female (P < 0.001). Time series analysis using an autoregressive integrated moving average model revealed a significant decrease in SRC (P < 0.001) incidence; NSRC incidence showed no decline. There was no difference in H. pylori infection prevalence between the SRC and NSRC groups. IHC and genomic methods detected H. pylori in 30 of 37 (81.1%) SRCs.
Reduction in H. pylori infection prevalence may be associated with the decrease in the incidence of SRC, which was higher than that of NSRC.
研究表明，胃癌（GC）的发病率有所下降，而印戒细胞癌（SRC）的发病率有所上升。然而，GC 发病率的近期趋势尚不清楚。我们利用医院癌症登记处的数据，评估了 GC、SRC 和非-SRC（NSRC）随时间的变化，并与 H. pylori 感染率随时间的变化进行了比较。
我们在我院癌症登记处确定了 2007 年 1 月至 2018 年 12 月期间登记的 2532 例 GC 患者，并对 SRC 和 NSRC 的发病率进行了统计学分析。通过血清抗 H. pylori 抗体检测、尿素呼气试验、活检标本培养和胃组织免疫组化分析（IHC）来确定 SRC 患者的 H. pylori 感染率。此外，还通过从福尔马林固定石蜡包埋的胃组织中提取 H. pylori 的 16S 核糖体 RNA 并对其进行基因检测来检测 SRC 中的 H. pylori。
总体而言，211 例患者为 SRC（8.3%）。与 NSRC 患者相比，SRC 患者更年轻（P<0.001），更可能为女性（P<0.001）。自回归积分移动平均模型的时间序列分析显示，SRC（P<0.001）的发病率显著下降；NSRC 的发病率没有下降。SRC 和 NSRC 组之间的 H. pylori 感染率没有差异。IHC 和基因方法在 37 例 SRC 中的 30 例（81.1%）中检测到 H. pylori。
H. pylori 感染率的降低可能与 SRC 发病率的下降有关，SRC 的发病率高于 NSRC。
