Hansson L R, Engstrand L, Nyrén O, Lindgren A
Department of Surgery, University Hospital, Uppsala, Sweden.
Gastroenterology. 1995 Sep;109(3):885-8. doi: 10.1016/0016-5085(95)90398-4.
BACKGROUND & AIMS: Although Helicobacter pylori has already been declared a human carcinogen, the exact nature of the association with gastric cancer remains to be explored. The aim of this study was to determine if the association is confined to specific types of gastric cancer.
The prevalence of H. pylori immunoglobulin G antibodies (HM-CAP immunoassay; Enteric Products Inc., Westbury, NY) was determined in prospectively collected sera from 279 patients with gastric cancer.
The overall prevalence of H. pylori seropositivity was 77%. The prevalence of H. pylori infection was significantly lower among patients with tumors of the gastric cardia compared with those with other gastric locations. Age-adjusted H. pylori seroprevalence among patients with the intestinal type of gastric cancer tended to be higher than among those with the diffuse type according to Laurén (P > 0.05). In both histological types, the seroprevalence decreased with increasing age. Multivariate logistic regression analysis showed that high age and proximal tumor location were independent predictors of absence of H. pylori.
The association with H. pylori infection is similar regardless of the histological features of the tumor, whereas it is stronger for noncardiac gastric cancer than for cardiac cancer. The apparent loss of H. pylori seropositivity among patients with gastric cancer is determined by age rather than tumor stage.
尽管幽门螺杆菌已被宣布为人类致癌物，但与胃癌关联的确切性质仍有待探索。本研究的目的是确定这种关联是否局限于特定类型的胃癌。
采用HM - CAP免疫测定法（纽约韦斯特伯里的Enteric Products Inc.公司生产），对前瞻性收集的279例胃癌患者血清中的幽门螺杆菌免疫球蛋白G抗体进行检测。
幽门螺杆菌血清阳性的总体患病率为77%。与其他胃部位肿瘤患者相比，贲门部肿瘤患者的幽门螺杆菌感染率显著更低。根据劳伦分类，肠型胃癌患者经年龄调整后的幽门螺杆菌血清阳性率往往高于弥漫型患者（P > 0.05）。在两种组织学类型中，血清阳性率均随年龄增长而降低。多因素逻辑回归分析显示，高龄和肿瘤近端位置是幽门螺杆菌阴性的独立预测因素。
无论肿瘤的组织学特征如何，与幽门螺杆菌感染的关联相似，而非贲门部胃癌与幽门螺杆菌感染的关联比贲门癌更强。胃癌患者中幽门螺杆菌血清阳性率的明显下降是由年龄而非肿瘤分期决定的。
