Tatsuta M, Iishi H, Nakaizumi A, Okuda S, Taniguchi H, Hiyama T, Tsukuma H, Oshima A
Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan.
Int J Cancer. 1993 Jan 2;53(1):70-4. doi: 10.1002/ijc.2910530114.
The role of atrophic gastritis of the gastric corpus (fundal atrophic gastritis) as a high-risk factor was investigated by studying operative findings and follow-up data on 690 patients with benign gastric diseases recorded at the Osaka Cancer Registry. The extent of fundal atrophic gastritis was determined by the endoscopic Congo red test. The patients were followed-up from the time of endoscopic examination (1968 to 1976) to December 31, 1987. The vital status of 654 patients (94.8%) at the end of the observation period was determined. During the follow-up period, 22 patients were found to have gastric cancer. The extent of fundal atrophic gastritis was shown to be closely related with the risk of developing gastric cancer. Patients who had been diagnosed as having severe fundal atrophic gastritis showed significantly higher risk of gastric cancer than patients who had been diagnosed as having little or no fundal atrophic gastritis (5.76-fold, calculated with adjustments for age, sex and the follow-up period). A positive linear relationship was found between the risk of developing gastric cancer and the extent of fundal atrophic gastritis. The observed number of gastric cancers was compared with the expected number calculated from the incidence in Osaka Prefecture. Analysis of the results showed that the observed and expected numbers of gastric cancers in patients with severe fundal atrophic gastritis were 11 and 4.8, respectively, the ratio of observed to expected numbers being 2.3 (p < 0.05). These findings indicate that severe fundal atrophic gastritis is a major risk factor for gastric cancer.
通过研究大阪癌症登记处记录的690例良性胃病患者的手术结果和随访数据，调查了胃体萎缩性胃炎（胃底萎缩性胃炎）作为高危因素的作用。胃底萎缩性胃炎的程度通过内镜刚果红试验确定。患者从内镜检查时（1968年至1976年）开始随访至1987年12月31日。确定了654例患者（94.8%）在观察期结束时的生命状态。在随访期间，发现22例患者患有胃癌。结果表明，胃底萎缩性胃炎的程度与患胃癌的风险密切相关。被诊断为患有严重胃底萎缩性胃炎的患者患胃癌的风险显著高于被诊断为患有轻度或无胃底萎缩性胃炎的患者（经年龄、性别和随访期调整后计算为5.76倍）。发现患胃癌的风险与胃底萎缩性胃炎的程度呈正线性关系。将观察到的胃癌病例数与根据大阪府发病率计算的预期病例数进行比较。结果分析表明，严重胃底萎缩性胃炎患者中观察到的和预期的胃癌病例数分别为11例和4.8例，观察数与预期数之比为2.3（p<0.05）。这些发现表明，严重胃底萎缩性胃炎是胃癌的主要危险因素。
