Ono Ayami, Tanaka Shiori, Sawada Norie, Goto Atsushi, Tsugane Shoichiro, Muraki Isao, Yamagishi Kazumasa, Sasaki Yu, Abe Yasuhiko, Kayama Takamasa, Ueno Yoshiyuki, Saito Eiko, Yamaji Taiki, Iwasaki Motoki, Inoue Manami
Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Division of Prevention, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
Sci Rep. 2025 Jul 1;15(1):21307. doi: 10.1038/s41598-025-00713-z.
Helicobacter pylori (H. pylori) infection is an established cause of gastric cancer. Although H. pylori eradication is suggested to decrease gastric cancer risk, this has not been fully investigated in general populations. This analysis included 48,530 Japanese men and women aged 40-74 years from four cohort studies. At baseline, the participants provided a self-reported eradication history and serum anti-H. pylori IgG titers and the results of a pepsinogen (PG) test. We examined the association between eradication history and gastric cancer risk considering H. pylori positivity and PG testing using Cox proportional hazards regression models. From 2010 to 2018, 649 gastric cancer cases were diagnosed. Compared with those who were negative for both H. pylori and PG test as a reference, gastric cancer risk was 5.89 times higher (95%CI: 4.41-7.87) in those who were H. pylori-positive and/or PG test-positive and with no eradication at baseline. Gastric cancer risk among those who underwent eradication before baseline decreased after a temporal increase in risk following eradication (baseline to < 1y: HR 1.74, 95%CI 1.18-2.57; 1y to < 6y: HR 0.81, 95%CI 0.59-1.11; ≥ 6y: HR 0.44, 95%CI 0.28-0.68). In this large Japanese general population, H. pylori eradication was associated with a long-term reduction in gastric cancer incidence.
幽门螺杆菌（H. pylori）感染是胃癌的既定病因。尽管建议根除幽门螺杆菌以降低胃癌风险，但在普通人群中尚未对此进行充分研究。该分析纳入了来自四项队列研究的48530名年龄在40 - 74岁的日本男性和女性。在基线时，参与者提供了自我报告的根除史、血清抗幽门螺杆菌IgG滴度以及胃蛋白酶原（PG）检测结果。我们使用Cox比例风险回归模型，考虑幽门螺杆菌阳性和PG检测情况，研究了根除史与胃癌风险之间的关联。2010年至2018年期间，共诊断出649例胃癌病例。以幽门螺杆菌和PG检测均为阴性的人群作为对照，在基线时幽门螺杆菌阳性和/或PG检测阳性且未根除的人群中，胃癌风险高5.89倍（95%CI：4.41 - 7.87）。在基线前接受根除治疗的人群中，胃癌风险在根除后风险暂时升高后下降（基线至<1年：HR 1.74，95%CI 1.18 - 2.57；1年至<6年：HR 0.81，95%CI 0.59 - 1.11；≥6年：HR 0.44，95%CI 0.28 - 0.68）。在这个庞大的日本普通人群中，根除幽门螺杆菌与胃癌发病率的长期降低有关。
