Hu P J, Li Y Y, Lin H L, Zhou S M, Du G, Chen M H, Mitchell H M, Hazell S L
Affiliated First Hospital, Sun Yat-Sen University of Medical Science, Guangzhou, China.
Am J Gastroenterol. 1995 Jul;90(7):1102-6.
To compare the upper gastrointestinal disease profiles of Helicobacter pylori-infected patients drawn from two distinct regions of China, one with a low incidence of gastric cancer (Guangzhou) and the other with a high incidence of gastric cancer (Lanzhou). The age-standardized prevalence of H. pylori within the populations of these two cities was similar (approximately 56%). In these patient groups, the prevalence of different gastrointestinal disease states and the occurrence and severity of gastritis, gastric atrophy, and intestinal metaplasia were compared.
This study was based on consecutive patients: 265 from Guangzhou and 275 from Lanzhou. The grading of gastritis and the detection of H. pylori was determined by histology using the "Sydney System".
The ratio of cases of duodenal to gastric ulceration for the two cities was: Guangzhou 14:1 and Lanzhou 3:1. Gastric cancer was more prevalent in the patients from Lanzhou (9.8%) than from Guangzhou (3%). In nonulcer dyspepsia patients from Guangzhou, gastritis was predominantly antral, whereas, in Lanzhou, gastritis was predominantly uniform. The amount and severity of atrophy was significantly greater in Lanzhou compared with Guangzhou.
The prevalence of atrophy, rather than age of acquisition and prevalence of H. pylori infection, appears to be a marker of the major upper gastrointestinal disease profiles of a region. Development of atrophy, although apparently related to H. pylori infection, may be a multifactorial condition. Differences in diet, as seen between Guangzhou and Lanzhou, may be important in this regard. Understanding the factors leading to the development of atrophy may enhance our understanding of processes leading to gastric malignancy.
比较来自中国两个不同地区的幽门螺杆菌感染患者的上消化道疾病谱，一个地区胃癌发病率低（广州），另一个地区胃癌发病率高（兰州）。这两个城市人群中幽门螺杆菌的年龄标准化患病率相似（约56%）。在这些患者组中，比较了不同胃肠道疾病状态的患病率以及胃炎、胃萎缩和肠化生的发生情况及严重程度。
本研究基于连续纳入的患者：广州265例，兰州275例。采用“悉尼系统”通过组织学确定胃炎分级和幽门螺杆菌检测。
两个城市十二指肠溃疡与胃溃疡病例的比例为：广州14:1，兰州3:1。兰州患者的胃癌患病率（9.8%）高于广州患者（3%）。广州非溃疡性消化不良患者中，胃炎主要位于胃窦部，而在兰州，胃炎多为弥漫性。与广州相比，兰州萎缩的程度和严重程度明显更高。
萎缩的患病率似乎是一个地区主要上消化道疾病谱的标志，而非幽门螺杆菌感染的获得年龄和患病率。萎缩的发展虽然显然与幽门螺杆菌感染有关，但可能是一种多因素情况。广州和兰州在饮食方面的差异在这方面可能很重要。了解导致萎缩发展的因素可能会增进我们对导致胃癌的过程的理解。
