中国福建胃癌的危险因素及相关血清学水平：基于医院的病例对照研究。
Risk factors for gastric cancer and related serological levels in Fujian, China: hospital-based case-control study.
作者信息
Yuan Ping, Lin Lan, Zheng Kuicheng, Wang Wen, Wu Sihan, Huang Liangxiang, Wu Bingshan, Chen Tiehui, Li Xiaoqing, Cai Lin
机构信息
Fujian Key Laboratory of Zoonoses Research, Fujian Center for Disease Control and Prevention, Fuzhou, Fujian, China.
School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.
出版信息
BMJ Open. 2020 Sep 22;10(9):e042341. doi: 10.1136/bmjopen-2020-042341.
OBJECTIVE
To explore the relationships between gastric cancer and serum pepsinogen I (PG I), PG II, PG I/II ratio, gastrin 17 (G-17) and infection, and to investigate dietary and lifestyle risk factors for gastric cancer in Fujian Province, China.
DESIGN
A hospital-based, 1:1 matched case-control study.
SETTING
Patients with newly diagnosed gastric cancer were recruited from the Fujian Provincial Hospital and the No. 900 Hospital of the Joint Support Force of the Chinese People's Liberation Army between July 2014 and December 2016.
PARTICIPANTS
A total of 180 pairs of patients with gastric cancer and control subjects were recruited in the study, including 134 (74.4%) male pairs and 46 (25.6%) female pairs.
INVESTIGATION AND ANALYSIS MEASURES
Serological indicators were tested with ELISA kits. Dietary, lifestyle and psychological factors were investigated through face-to-face questionnaire. Relationships between gastric cancer and these influencing factors were examined by Χ test and conditional logistic regression.
RESULTS
Serum PG II and G-17 levels and infection rate were higher in patients with gastric cancer than in control subjects (p<0.05), while PG I/II ratio was lower in patients with gastric cancer (p<0.05). Serum G-17 levels were higher in patients with corpus gastric cancer than in patients with antral gastric cancer (p<0.05). Serum PG II levels were higher in patients with advanced gastric cancer than in patients with early-stage cancer (p<0.05), however, PG I/II ratio was lower in patients with advanced-stage gastric cancer than in patients with early-stage cancer (p<0.05). Eating hot food (OR=2.32), eating pickled vegetables (OR=4.05) and often feel troubled (OR=2.21) were found to significantly increase the risk of gastric cancer (all p<0.05), while consuming onion or garlic (OR=0.35), drinking tea (OR=0.26), eating fresh fruits (OR=0.55), and high serum PG I (OR=0.99) or PG I/II ratio (OR=0.73) were found to be protective against gastric cancer.
CONCLUSION
Study results showed that serum PG, G-17 and antibodies could be useful indicators for early diagnosis of gastric cancer. Increase in serum G-17 level might indicate the location of gastric cancer. Increase in serum PG II level and decrease in PG I/II ratio might imply the clinical stage. Eating hot food, eating pickled vegetables and often feel troubled may be risk factors for gastric cancer, while eating fresh fruits, eating onion or garlic, and drinking tea may be protective factors against the disease.
目的
探讨胃癌与血清胃蛋白酶原I（PG I）、胃蛋白酶原II（PG II）、PG I/II比值、胃泌素17（G - 17）及幽门螺杆菌感染的关系，并调查中国福建省胃癌的饮食和生活方式危险因素。
设计
一项基于医院的1:1匹配病例对照研究。
设置
2014年7月至2016年12月期间，从福建省立医院和中国人民解放军联勤保障部队第九〇〇医院招募新诊断的胃癌患者。
参与者
本研究共招募了180对胃癌患者和对照者，其中男性对134对（74.4%），女性对46对（25.6%）。
调查与分析方法
采用ELISA试剂盒检测血清学指标。通过面对面问卷调查饮食、生活方式和心理因素。采用χ²检验和条件logistic回归分析胃癌与这些影响因素之间的关系。
结果
胃癌患者血清PG II、G - 17水平及幽门螺杆菌感染率高于对照者（p<0.05），而胃癌患者PG I/II比值较低（p<0.05）。胃体癌患者血清G - 17水平高于胃窦癌患者（p<0.05）。进展期胃癌患者血清PG II水平高于早期胃癌患者（p<0.05），然而，进展期胃癌患者PG I/II比值低于早期胃癌患者（p<0.05）。发现食用热食（OR = 2.32）、食用腌制蔬菜（OR = 4.05）和经常感到烦恼（OR = 2.21）会显著增加患胃癌的风险（均p<0.05），而食用洋葱或大蒜（OR = 0.35）、喝茶（OR = 0.26）、食用新鲜水果（OR = 0.55）以及高血清PG I（OR = 0.99）或PG I/II比值（OR = 0.73）对胃癌有保护作用。
结论
研究结果表明，血清PG、G - 17和幽门螺杆菌抗体可能是胃癌早期诊断的有用指标。血清G - 17水平升高可能提示胃癌的位置。血清PG II水平升高和PG I/II比值降低可能意味着临床分期。食用热食、食用腌制蔬菜和经常感到烦恼可能是胃癌的危险因素，而食用新鲜水果、食用洋葱或大蒜和喝茶可能是预防该疾病的保护因素。
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