Craanen M E, Blok P, Dekker W, Tytgat G N
Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
Gut. 1994 Oct;35(10):1372-4. doi: 10.1136/gut.35.10.1372.
The relation between Helicobacter pylori, intestinal metaplasia, and early gastric cancer was studied by examining gastrectomy specimens from 31 intestinal type and 22 diffuse type carcinomas. A total of 298 patients with antral gastritis were used as controls. Atrophic changes and intestinal metaplasia were significantly more common in intestinal type early gastric cancer compared with diffuse type early gastric cancer (p < 0.05 and p < 0.001, respectively). H pylori was found in 61.3% of intestinal type early gastric cancer and in 54.5% of diffuse type early gastric cancer (NS). The age adjusted prevalence of intestinal metaplasia in the patients with antral gastritis was higher in H pylori positive patients in all age groups studied. Comparing gastritis patients with patients with intestinal type early gastric cancer showed the age adjusted prevalence of intestinal metaplasia to be significantly higher in the patients with early gastric cancer in all age groups studied. In conclusion, H pylori is associated with both types of early gastric carcinoma. Intestinal metaplasia formation seems to be a multifactorial process in which H pylori may play a part. These findings suggest that gastric cancer may be included in the spectrum of H pylori associated diseases, although many questions about causality remain to be answered.
通过检查31例肠型和22例弥漫型胃癌的胃切除标本，研究了幽门螺杆菌、肠化生与早期胃癌之间的关系。共有298例胃窦炎患者作为对照。与弥漫型早期胃癌相比，萎缩性改变和肠化生在肠型早期胃癌中明显更为常见（分别为p < 0.05和p < 0.001）。在61.3%的肠型早期胃癌和54.5%的弥漫型早期胃癌中发现了幽门螺杆菌（无统计学差异）。在所研究的所有年龄组中，胃窦炎患者中幽门螺杆菌阳性患者的肠化生年龄校正患病率较高。比较胃炎患者和肠型早期胃癌患者发现，在所研究的所有年龄组中，早期胃癌患者的肠化生年龄校正患病率明显更高。总之，幽门螺杆菌与两种类型的早期胃癌均有关联。肠化生的形成似乎是一个多因素过程，其中幽门螺杆菌可能起一定作用。这些发现表明，胃癌可能被纳入幽门螺杆菌相关疾病的范畴，尽管关于因果关系仍有许多问题有待解答。
