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根治治疗后中老年日本人幽门螺杆菌抗体滴度的长期应答:JPHC-NEXT 研究。

Long-term Response of Helicobacter pylori Antibody Titer After Eradication Treatment in Middle-aged Japanese: JPHC-NEXT Study.

机构信息

Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center.

Department of Health Data Science, Graduate School of Data Science, Yokohama City University.

出版信息

J Epidemiol. 2023 Jan 5;33(1):1-7. doi: 10.2188/jea.JE20200618. Epub 2021 Oct 19.

Abstract

BACKGROUND

Helicobacter pylori (H. pylori) is an established causative factor of gastric cancer. Although the expansion of insurance coverage has led to an increase in the number of patients treated for H. pylori, the population impact of eradication treatment for H. pylori has been scarcely investigated. This study aimed to clarify the long-term responses of H. pylori antibody titer after eradication treatment using large scale cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT Study).

METHODS

A total of 55,282 Japanese participants aged 40 to 74 years residing in 16 areas provided blood samples from 2011 through 2016. From these, treated (n = 6,276) and untreated subjects who were seropositive for H. pylori or had serological atrophy (n = 22,420) formed the study population (n = 28,696). Seropositivity was defined as an anti-H. pylori IgG titer of ≥10 U/mL. Antibody level was compared among subjects according to self-reported treatment history as untreated, and treated for less than 1 year (<1Y), 1 through 5 years (1-5Y), and 6 or more years ago (6Y+).

RESULTS

Median serum antibody titer was 34.0 U/mL, 7.9 U/mL, 4.0 U/mL, and 2.9 U/mL for the untreated, <1Y, 1-5Y, and 6Y+ groups, respectively. While those treated for H. pylori within the previous year had a 76.8% lower antibody titer compared to untreated subjects, approximately 41% of subjects were still seropositive.

CONCLUSION

A significant reduction in H. pylori antibody titer occurs within 1 year after eradication treatment, but that a long period is needed to achieve complete negative conversion.

摘要

背景

幽门螺杆菌(H. pylori)已被确认为胃癌的致病因素。尽管医疗保险范围的扩大导致接受 H. pylori 治疗的患者数量增加,但对 H. pylori 根除治疗的人群影响尚未得到充分研究。本研究旨在使用来自日本公共卫生中心前瞻性下一代研究(JPHC-NEXT 研究)的大规模横断面数据,阐明根除治疗后 H. pylori 抗体滴度的长期反应。

方法

共有 16 个地区的 55282 名年龄在 40 至 74 岁之间的日本参与者在 2011 年至 2016 年期间提供了血液样本。其中,治疗组(n=6276)和未经治疗但 H. pylori 血清阳性或存在血清萎缩的患者(n=22420)形成了研究人群(n=28696)。血清阳性定义为抗 H. pylori IgG 滴度≥10 U/mL。根据自我报告的治疗史,将抗体水平与未治疗、治疗时间<1 年(<1Y)、1-5 年(1-5Y)和 6 年以上(6Y+)的患者进行比较。

结果

未治疗、<1Y、1-5Y 和 6Y+组的血清抗体滴度中位数分别为 34.0 U/mL、7.9 U/mL、4.0 U/mL 和 2.9 U/mL。与未治疗的患者相比,在过去 1 年内接受 H. pylori 治疗的患者抗体滴度降低了 76.8%,但仍有约 41%的患者呈血清阳性。

结论

根除治疗后 H. pylori 抗体滴度显著降低,但需要很长时间才能达到完全阴性转换。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be68/9727212/c1c1c00c2871/je-33-001-g001.jpg

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