Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
The Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
PLoS One. 2022 Jul 21;17(7):e0265885. doi: 10.1371/journal.pone.0265885. eCollection 2022.
H. pylori (Hp) infection has been indicated in the pathogenesis of gastric diseases including gastric cancer (GC). This study aimed at exploring the relationships between Hp infection and gastric diseases including GC in a large dataset of routine patients undergoing gastroscopy.
From November 2007 to December 2017, 70,534 first-time visiting patients aged 18-94 years with gastroscopic biopsies were histologically diagnosed and analyzed. Patients' data were entered twice in an Excel spreadsheet database and analyzed using the SPSS (version 22.0) software package and statistical significance was defined as P<0.05 for all analyses.
The first interesting observation was age-related twin-peak prevalence profiles (TPPs) for Hp infection, gastritis, and advanced diseases with different time spans (TS) between the first and second occurring peaks. Hp infection and gastritis had TPPs occurring at earlier ages than TPPs of gastric introepithelial neoplasia (GIN) and GC. More patients were clustered at the second occurring TPPs. The time spans (TS) from the first occurring peak of Hp infection to the first occurring peaks of other gastric diseases varied dramatically with 0-5 years for gastritis; 5-15 years for GINs, and 5-20 years for GC, respectively. The number of males with Hp infection and gastric diseases, excluding non-atrophic gastritis (NAG), was more than that of females (P<0.001).
We have first observed age-related twin-peak prevalence profiles for Hp infection, gastritis, GIN, and GC, respectively, among a large population of patients undergoing gastroscopy. The second prevalence peak of GC is at ages of 70-74 years indicating that many GC patients would be missed during screening because the cut-off age for screening is 69 years old in China.
幽门螺杆菌（Hp）感染已被认为与包括胃癌（GC）在内的多种胃部疾病的发病机制有关。本研究旨在通过对大量接受胃镜检查的常规患者的数据集进行研究，探索 Hp 感染与包括 GC 在内的胃部疾病之间的关系。
2007 年 11 月至 2017 年 12 月，对 70534 名年龄在 18-94 岁之间、接受胃镜活检的首次就诊患者进行了组织学诊断和分析。患者数据两次输入 Excel 电子表格数据库，使用 SPSS（版本 22.0）软件包进行分析，所有分析均定义为 P<0.05 有统计学意义。
首先观察到与年龄相关的 Hp 感染、胃炎和高级别疾病的双峰流行率曲线（TPP），且两个峰之间的时间跨度（TS）不同。Hp 感染和胃炎的 TPP 发生在比胃上皮内瘤变（GIN）和 GC 的 TPP 更早的年龄。更多的患者聚集在第二个 TPP 发生的时间。从 Hp 感染的第一个峰到其他胃部疾病的第一个峰的时间跨度（TS）差异很大，胃炎为 0-5 年；GIN 为 5-15 年；GC 为 5-20 年。患有 Hp 感染和胃部疾病（不包括非萎缩性胃炎（NAG））的男性数量多于女性（P<0.001）。
我们首次在接受胃镜检查的大量患者中观察到与年龄相关的 Hp 感染、胃炎、GIN 和 GC 的双峰流行率曲线。GC 的第二个流行峰出现在 70-74 岁年龄组，表明由于中国的筛查截止年龄为 69 岁，许多 GC 患者在筛查时会被遗漏。
