Parsonnet J
Stanford University School of Medicine, California.
Gastroenterol Clin North Am. 1993 Mar;22(1):89-104.
Gastric cancer remains among the leading types of cancer worldwide. There is now convincing evidence linking H. pylori to adenocarcinomas of the gastric antrum, body, and fundus. These tumors are rapidly decreasing in incidence in the United States, whereas cardia tumors, tumors unassociated with H. pylori infection, are on the increase. Although criteria for causality have not been completely fulfilled for H. pylori and adenocarcinoma, there are plausible mechanisms by which chronic inflammation could induce carcinogenesis ("mitosis causes mutagenesis"). Because gastric cancer is unusual in the United States, screening and treatment of H. pylori in the general population are unwarranted. Chemoprevention in high-risk populations, however, could potentially be used to decrease risk for adenocarcinomas distal to the cardia.
胃癌仍是全球主要的癌症类型之一。目前有确凿证据表明幽门螺杆菌与胃窦、胃体和胃底的腺癌有关。在美国，这些肿瘤的发病率正在迅速下降，而贲门部肿瘤，即与幽门螺杆菌感染无关的肿瘤，却在增加。尽管幽门螺杆菌与腺癌之间的因果关系标准尚未完全满足，但存在慢性炎症可诱导致癌的合理机制（“有丝分裂导致诱变”）。由于胃癌在美国并不常见，因此对普通人群进行幽门螺杆菌筛查和治疗是不必要的。然而，对高危人群进行化学预防可能会降低贲门远端腺癌的风险。
