幽门螺杆菌、胃癌前病变及胃癌的流行病学：一项基于南京多中心人群的横断面研究
Epidemiology of Helicobacter pylori, gastric precancerous lesions and gastric cancer: a multicenter, population-based cross-sectional study in Nanjing.
作者信息
Niu Chunyan, Song Yongqiang, Chen Yue, Shi Yongqiang, Wang Hui, Wu Xinguo, Wang Xiaoping, Zhao Xiangyang, Bu Yongdan, Li Jijin, Tao Tao, Wu Jinhua, Xue Changlin, Zhang Fuyu, Han Chunrong, Yuan Juan, Zhang Qiang
机构信息
Department of Gastroenterology, Nanjing Lishui People's Hospital (Zhongda Hospital Lishui Branch, Southeast University), Nanjing, 211200, China.
Dongping Street Health Center in Nanjing Lishui District, Nanjing, 211212, China.
出版信息
BMC Infect Dis. 2025 May 27;25(1):766. doi: 10.1186/s12879-025-11147-3.
BACKGROUND
Nanjing City has a high-incidence gastric cancer (GC), but the epidemiology of gastric precancerous lesions (GPLs) remains poorly understood. This study aimed to investigate the epidemiological characteristics of Helicobacter pylori (H. pylori) infection, GPLs, and GCs in patients undergoing endoscopic examination in Lishui District, Nanjing.
METHODS
This retrospective, population-based, cross-sectional study was conducted collaboratively by the Nanjing Lishui People's Hospital and six medical community units within the county between July 2022 and June 2023. Data on biopsies and C urea breath tests (C-UBT) were collected.
RESULTS
A total of 15,668 individuals were included, among whom 259 had GPL (1.65%) and 218 had GC (1.39%). The H. pylori infection rate in total patients was 5014 (32.00%) (males: 2684 (34.06%); females: 2335 (29.92%)). The H. pylori infection rate is 31.45% in benign gastric lesions, 44.40% in GPLs, and 55.50% in GC, respectively. The multivariable logistic regression analysis showed that male (OR = 3.156, 95% CI: 2.865-3.376, P < 0.001), age (OR = 1.785, 95% CI: 1.703-1.876, P < 0.001), fresh vegetable, fruit, and white meat intake frequently (OR = 0.865, 95% CI: 0.506-2.061, P = 0.029), high-salt diet and high-fat diet intake frequently (OR = 1.906, 95% CI: 1.101-2.932, P = 0.014), rural residence (OR = 2.682, 95% CI: 1.010-4.754, P = 0.040), H. pylori infection (OR = 2.022, 95% CI: 1.155-2.865, P < 0.001) and atrophic gastritis and/or intestinal metaplasia (OR = 4.875, 95% CI: 2.229-10.663, P < 0.001) were associated with GPLs. Male (OR = 2.021, 95% CI: 1.080-3.780, P = 2.028), age (OR = 1.201, 95% CI: 1.174-1.238, P < 0.001), digestive symptoms (OR = 2.256, 95% CI: 1.548-3.289, P < 0.001), bachelor degree below (OR = 4.792, 95% CI: 3.439-6.837, P < 0.001), farmer (OR = 1.039, 95% CI: 1.026-1.159, P < 0.001), fresh vegetable, fruit, and white meat intake (OR = 0.231, 95% CI: 0.141-0.379, P < 0.001), fried/barbecue/pickled food intake (OR = 6.781, 95% CI: 3.783-12.153, P < 0.001), high-salt diet and high-fat diet intake (OR = 4.374, 95% CI: 2.363-8.097, P < 0.001), rural residence (OR = 1.230, 95% CI: 1.121-1.437, P < 0.001), H. pylori infection (OR = 3.248, 95% CI: 2.357-4.477, P < 0.001) and atrophic gastritis and/or intestinal metaplasia (OR = 4.875, 95% CI: 2.636-9.016, P < 0.001) were associated with GCs.
CONCLUSIONS
These findings underscore the importance of implementing targeted prevention strategies and early detection programs in high-risk populations to mitigate the burden of GPLs and GCs in Nanjing.
背景
南京市胃癌（GC）发病率较高，但对胃癌前病变（GPLs）的流行病学仍知之甚少。本研究旨在调查南京市溧水区接受内镜检查患者中幽门螺杆菌（H. pylori）感染、GPLs和GC的流行病学特征。
方法
本研究为回顾性、基于人群的横断面研究，由南京市溧水区人民医院与该县6个医疗社区单位于2022年7月至2023年6月合作开展。收集活检和碳尿素呼气试验（C-UBT）数据。
结果
共纳入15668例个体，其中259例有GPL（1.65%），218例有GC（1.39%）。总患者中H. pylori感染率为5014例（32.00%）（男性：2684例（34.06%）；女性：2335例（29.92%））。H. pylori感染率在良性胃部病变中为31.45%，在GPLs中为44.40%，在GC中为55.50%。多变量逻辑回归分析显示，男性（OR = 3.156，95%CI：2.865 - 3.376，P < 0.001）、年龄（OR = 1.785，95%CI：1.703 - 1.876，P < 0.001）、经常摄入新鲜蔬菜、水果和白肉（OR = 0.865，95%CI：0.506 - 2.061，P = 0.029）、经常摄入高盐饮食和高脂肪饮食（OR = 1.906，95%CI：1.101 - 2.932，P = 0.014）、农村居住（OR = 2.682，95%CI：1.010 - 4.754，P = 0.040）、H. pylori感染（OR = 2.022，95%CI：1.155 - 2.865，P < 0.001）以及萎缩性胃炎和/或肠化生（OR = 4.875，95%CI：2.229 - 10.663，P < 0.001）与GPLs相关。男性（OR = 2.021，95%CI：1.080 - 3.780，P = 2.028）、年龄（OR = 1.201，95%CI：1.174 - 1.238，P < 0.001）、消化症状（OR = 2.256，95%CI：1.548 - 3.289，P < 0.001）、本科以下学历（OR = 4.792，95%CI：3.439 - 6.837，P < 0.001）、农民（OR = 1.039，95%CI：1.026 - 1.159，P < 0.001）、新鲜蔬菜、水果和白肉摄入量（OR = 0.
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