Kuipers E J, Gracia-Casanova M, Peña A S, Pals G, Van Kamp G, Kok A, Kurz-Pohlmann E, Pels N F, Meuwissen S G
Dept. of Gastroenterology, Free University Hospital, Amsterdam, The Netherlands.
Scand J Gastroenterol. 1993 May;28(5):433-7. doi: 10.3109/00365529309098245.
Helicobacter pylori-associated gastritis has been put forward as a distinct risk factor for gastric cancer. Furthermore, among H. pylori-positive individuals a correlation between a high serum level of H. pylori antibodies and the risk of gastric cancer has been found in two different studies. Other studies have challenged this hypothesis. We therefore studied the presence and level of H. pylori serum antibodies, using an enzyme-linked immunosorbent assay technique in 116 gastric cancer patients (65 men; mean age, 67 years; range, 23-92 years) and 116 controls matched for age and sex. Patients and controls were selected on referral for gastroscopy. The prevalence of infection in gastric cancer patients was 77% (89 of 116) and in controls 79% (92 of 116). This difference is not statistically significant, nor is the prevalence of infection in cases and controls of different age cohorts significantly different. High levels of serum antibodies were found in 46% (53 of 116) of gastric cancer patients and 40% (46 of 116) of controls. Comparison of the prevalence of high serum levels of antibodies for the total population and for the different age cohorts did not show significant differences either. We conclude that the comparison of actual H. pylori infection in a cross-sectional study of gastric cancer patients and controls does not enable relative risk calculation in the study of the role of H. pylori infection in gastric carcinogenesis. Prospective studies showing diminishment of the risk for gastric cancer after eradication of H. pylori are required.
幽门螺杆菌相关性胃炎已被提出是胃癌的一个独特危险因素。此外，在两项不同的研究中发现，在幽门螺杆菌阳性个体中，高血清水平的幽门螺杆菌抗体与胃癌风险之间存在相关性。其他研究对这一假设提出了质疑。因此，我们使用酶联免疫吸附测定技术，对116例胃癌患者（65名男性；平均年龄67岁；范围23 - 92岁）和116名年龄和性别相匹配的对照者进行了研究，以检测幽门螺杆菌血清抗体的存在情况和水平。患者和对照者均因胃镜检查转诊而入选。胃癌患者的感染率为77%（116例中的89例），对照者的感染率为79%（116例中的92例）。这种差异无统计学意义，不同年龄组病例和对照者的感染率也无显著差异。46%（116例中的53例）的胃癌患者和40%（116例中的46例）的对照者血清抗体水平较高。对总体人群和不同年龄组高血清抗体水平患病率的比较也未显示出显著差异。我们得出结论，在胃癌患者和对照者的横断面研究中，对实际幽门螺杆菌感染情况进行比较，无法在研究幽门螺杆菌感染在胃癌发生中的作用时计算相对风险。需要进行前瞻性研究，以表明根除幽门螺杆菌后胃癌风险降低。
