Asaka M, Kato M, Kudo M, Katagiri M, Nishikawa K, Yoshida J, Takeda H, Miki K
Third Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Eur J Gastroenterol Hepatol. 1995 Aug;7 Suppl 1:S7-10.
To evaluate the possible relationship between Helicobacter pylori infection and gastric carcinoma, and its precursor lesion, intestinal metaplasia, in a Japanese population.
H. pylori infection was identified by the presence of anti-H. pylori immunoglobulin (Ig)G. The frequency of H. pylori infection was compared in 109 patients with gastric carcinoma, the same number of patients with atrophic gastritis and asymptomatic controls matched for age, sex and place of birth. To study the relation between H. pylori and intestinal metaplasia, sera and gastric antral and corpus mucosal biopsies were obtained from 58 asymptomatic controls, 92 patients with chronic gastritis and 80 patients with peptic ulcer.
The presence of IgG antibody to H. pylori was significantly more frequent in those with gastric carcinoma than in asymptomatic controls (87.2 versus 74.3%; odds ratio 2.4; 95% confidence interval 1.2-4.8). The positive rates of H. pylori IgG antibody were 80.7% in patients with atrophic gastritis. Mean serum gastrin and pepsinogen II levels in H. pylori-positive patients were higher than those in H. pylori-negative patients. Serum gastrin and pepsinogen I levels were significantly higher in controls than gastric carcinoma patients (P < 0.01 and P < 0.05, respectively). Serum pepsinogen I:II ratios were significantly lower in controls than in gastric carcinoma patients (P < 0.01). Intestinal metaplasia was strongly associated with H. pylori infection, and was only found in patients with IgG antibodies to H. pylori.
These results suggest that H. pylori infection is associated with the development of gastric cancer by providing a suitable environment for carcinogenesis of the gastric mucosa, such as gastric atrophy and intestinal metaplasia.
评估在日本人群中幽门螺杆菌感染与胃癌及其癌前病变肠化生之间的可能关系。
通过抗幽门螺杆菌免疫球蛋白（Ig）G的存在来确定幽门螺杆菌感染情况。比较了109例胃癌患者、相同数量的萎缩性胃炎患者以及年龄、性别和出生地匹配的无症状对照者中幽门螺杆菌感染的频率。为研究幽门螺杆菌与肠化生的关系，从58例无症状对照者、92例慢性胃炎患者和80例消化性溃疡患者中获取血清以及胃窦和胃体黏膜活检样本。
胃癌患者中幽门螺杆菌IgG抗体的存在频率显著高于无症状对照者（87.2%对74.3%；优势比2.4；95%置信区间1.2 - 4.8）。萎缩性胃炎患者中幽门螺杆菌IgG抗体阳性率为80.7%。幽门螺杆菌阳性患者的血清胃泌素和胃蛋白酶原II水平高于幽门螺杆菌阴性患者。对照组的血清胃泌素和胃蛋白酶原I水平显著高于胃癌患者（分别为P < 0.01和P < 0.05）。对照组的血清胃蛋白酶原I:II比值显著低于胃癌患者（P < 0.01）。肠化生与幽门螺杆菌感染密切相关，且仅在幽门螺杆菌IgG抗体阳性的患者中发现。
这些结果表明，幽门螺杆菌感染通过为胃黏膜致癌提供适宜环境，如胃萎缩和肠化生，与胃癌的发生有关。
