Stemmermann G, Haenszel W, Locke F
J Natl Cancer Inst. 1977 Jan;58(1):13-20. doi: 10.1093/jnci/58.1.13.
This case-control study of Hawaiian Japanese indicated that gastric ulcer in the proximal portion of the pyloric antrum has features similar to those of gastric cancer. Such ulcers occurred at sites most frequently and most severely affected by intestinal metaplasia, although metaplasia tended to be more extensive with cancer than with ulcer. Metaplastic mucosa was more vulnerable to the action of pepsin and acid than was normal mucosa. The risk of ulceration would rise when a sufficiently lagrge area of the antrum was intestinalized and when the corpus continued to produce significant quantities of these substances. This study showed a strong association between salt intake, ulcer, and metaplasia. Significant but less dramatic associations were demonstrated between metaplasia and the use of traditional Japanese foods and smoking. The question was raised as to whether salt promotes ulceration or whether it potentiates the action of a mutagen that causes intestinal metaplasia.
这项针对夏威夷日裔的病例对照研究表明，幽门窦近端的胃溃疡具有与胃癌相似的特征。此类溃疡发生在肠化生最频繁且最严重的部位，尽管与溃疡相比，癌症时的化生往往更广泛。化生黏膜比正常黏膜更易受胃蛋白酶和酸的作用影响。当胃窦有足够大面积发生肠化生且胃体持续产生大量这些物质时，溃疡风险会升高。这项研究表明盐摄入、溃疡和化生之间存在密切关联。化生与食用传统日本食物及吸烟之间也显示出显著但不太明显的关联。有人提出疑问，是盐促进了溃疡形成，还是它增强了导致肠化生的诱变剂的作用。
