Chen Zhaofeng, Zheng Ya, Fan Ping, Li Min, Liu Wei, Yuan Hao, Liu Xin, Zhang Zhiyi, Wu Zhengqi, Wang Yuping, Ji Rui, Guo Qinghong, Ye Yuwei, Zhang Jinhua, Li Xiaohua, An Feng, Lu Linzhi, Li Youpeng, Wang Xiang, Zhang Jun, Guan Quanlin, Li Qiang, Liu Min, Ren Qian, Hu Xiaobin, Lu Hong, Zhang Hongling, Zhao Yue, Gou Xi, Shu Xiaochuang, Wang Jun, Hu Zenan, Xue Siqian, Liu Jiankang, Zhou Yongning
Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Front Microbiol. 2023 Jan 12;13:1024155. doi: 10.3389/fmicb.2022.1024155. eCollection 2022.
Several risk factors have been identified for the development of gastric adenocarcinoma (GAC), where the control group was usually a healthy population. However, it is unclear at what stage known risk factor exert their influence toward the progression to cancer. Based on the Wuwei Cohort, we enrolled 1,739 patients with chronic non-atrophic gastritis (no-CAG), 3,409 patients with chronic atrophic gastritis (CAG), 1,757 patients with intestinal metaplasia (IM), 2,239 patients with low-grade dysplasia (LGD), and 182 patients with high-grade dysplasia (HGD) or GAC to assess the risk factors between each two consecutive stages from no-CAG to GAC/HGD using adjusted logistic regression. We found that different groups of risk factors were associated with different stages. Age, occupation of farmer, low annual family income, () infection, drinking, eating hot food, histories of gastritis and peptic ulcer were associated with the development of CAG. Age, illiteracy, infection, smoking, eating hot food, eating quickly, and histories of gastritis and gallbladder diseases were associated with the progression to IM from CAG. Male, occupation of farmer and history of peptic ulcer were associated with the development of LGD from IM. Age, male and polyp history appeared to be risk factors associated with the development of GAC/HGD from LGD. In conclusion, it seems that most risk factors function more as a set of switches that initiated the GAC carcinogenesis. eradication and control of other risk factors should be conducted before IM to decrease the incidence of GAC.
已经确定了几个与胃腺癌（GAC）发生相关的风险因素，其中对照组通常为健康人群。然而，目前尚不清楚已知的风险因素在癌症进展的哪个阶段发挥作用。基于武威队列，我们纳入了1739例慢性非萎缩性胃炎（no-CAG）患者、3409例慢性萎缩性胃炎（CAG）患者、1757例肠化生（IM）患者、2239例低级别上皮内瘤变（LGD）患者以及182例高级别上皮内瘤变（HGD）或GAC患者，使用校正逻辑回归分析评估从no-CAG到GAC/HGD每两个连续阶段之间的风险因素。我们发现不同组的风险因素与不同阶段相关。年龄、农民职业、家庭年收入低、（）感染、饮酒、食用热食、胃炎病史和消化性溃疡病史与CAG的发生相关。年龄、文盲、感染、吸烟、食用热食、进食快以及胃炎和胆囊疾病病史与从CAG进展到IM相关。男性、农民职业和消化性溃疡病史与从IM发展为LGD相关。年龄、男性和息肉病史似乎是与从LGD发展为GAC/HGD相关的风险因素。总之，似乎大多数风险因素更像是启动GAC致癌过程的一组开关。在IM发生之前应进行（）根除和控制其他风险因素，以降低GAC的发病率。
