Sakaki N
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital.
Nihon Rinsho. 1993 Dec;51(12):3242-7.
To make clinical assessment regarding the role of Helicobacter pylori (H. pylori) in the occurrence of gastric cancer, we examined serological and microbiological positive rate of H. pylori and histological and endoscopic findings of atrophic gastritis of background mucosa in 149 gastric cancer patients, 136 gastric ulcer patients, 82 chronic gastritis cases and 46 normal control. Serological H. pylori positive rate examined using GAP-IgG in 43 gastric cancer patients was 95%, which was significantly higher than normal control (4%) but the same level as in chronic gastritis cases (87%) and gastric ulcer patients (93%). While, Microbiological H. pylori positive rate by culture was 62% in 149 gastric cancer, 7% in normal control, 74% in chronic gastritis and 80% in gastric ulcer. H. pylori infection and the degree of lymphocyte infiltration were significantly correlated and H. pylori was frequently detected in the cases with mild and moderate atrophic gastritis in all groups. No difference was observed in H. pylori positive rate between the well and poorly differentiated cancer cases; 96% and 94% by GAP-IgG, 57% and 66% by culture, respectively. As a conclusion, it was suspected that the relation between H. pylori infection and gastric cancer was indirect and associated with atrophic process of background mucosa.
为了对幽门螺杆菌(H. pylori)在胃癌发生中的作用进行临床评估,我们检测了149例胃癌患者、136例胃溃疡患者、82例慢性胃炎患者和46例正常对照者的幽门螺杆菌血清学和微生物学阳性率,以及背景黏膜萎缩性胃炎的组织学和内镜检查结果。43例胃癌患者中采用GAP-IgG检测的幽门螺杆菌血清学阳性率为95%,显著高于正常对照(4%),但与慢性胃炎患者(87%)和胃溃疡患者(93%)处于同一水平。同时,149例胃癌患者中通过培养检测的幽门螺杆菌微生物学阳性率为62%,正常对照为7%,慢性胃炎为74%,胃溃疡为80%。幽门螺杆菌感染与淋巴细胞浸润程度显著相关,且在所有组中,幽门螺杆菌在轻度和中度萎缩性胃炎病例中经常被检测到。高分化和低分化癌症病例之间的幽门螺杆菌阳性率未观察到差异;通过GAP-IgG检测分别为96%和94%,通过培养检测分别为57%和66%。结论是,怀疑幽门螺杆菌感染与胃癌之间的关系是间接的,且与背景黏膜的萎缩过程有关。