Kato S, Onda M, Matsukura N, Tokunaga A, Matsuda N, Yamashita K, Shields P G
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Cancer. 1996 Apr 15;77(8 Suppl):1654-61. doi: 10.1002/(SICI)1097-0142(19960415)77:8<1654::AID-CNCR35>3.0.CO;2-X.
Gastric cancer is a multistage process, each caused by numerous factors. The objective of this study was to elucidate the risk factors for gastric cancer by using molecular epidemiologic techniques and serum markers.
Serum pepsinogen I levels, pepsinogen I/pepsinogen II (I/II) ratios, serum IgG antibody against Helicobacter pylori (H. pylori), and genetic polymorphisms of cytochrome p450 2E1 (CYP2E1), glutathione-S-transferase M1 (GSTM1), and L-myc protooncogenes were analyzed in 82 persons with gastric cancer and in 151 age- and sex-matched controls, who were selected from 208 gastric cancer patients and 375 noncancer patients, respectively. Statistical analysis was performed to elucidate which risk factors for gastric cancer were contributing the most to gastric carcinogenicity.
Serum pepsinogen I level (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.04-3.16) and pepsinogen I/II ratios (OR = 3.09; 95% CI, 1.74-5.49) were significantly associated with gastric cancer risk in a case-control study. Seropositivity of serum IgG antibody against H. pylori (OR = 1.25; 95% CI, 0.84-1.85) and specific genotypes of a L-myc genetic polymorphism (OR = 1.33; 95% CI, 0.59-2.99) were more commonly observed in gastric cancer cases, but this was not statistically significant. Specific genotypes of the CYP2E1 RsaI polymorphism and GSTM1 gene deletion were not associated with gastric cancer.
Atrophic mucosal change, indicated by serum pepsinogen levels, is possible a risk factor for gastric cancer. H. pylori infection and genetic polymorphisms of CYP2E1, L-myc, and GSTM1 genetic polymorphisms were not risk factors in this study.
胃癌是一个多阶段过程，每个阶段由众多因素引起。本研究的目的是运用分子流行病学技术和血清标志物阐明胃癌的危险因素。
对82例胃癌患者和151例年龄及性别匹配的对照者进行血清胃蛋白酶原I水平、胃蛋白酶原I/胃蛋白酶原II（I/II）比值、抗幽门螺杆菌（H. pylori）血清IgG抗体以及细胞色素p450 2E1（CYP2E1）、谷胱甘肽-S-转移酶M1（GSTM1）和L-myc原癌基因的基因多态性分析，这些患者分别选自208例胃癌患者和375例非癌患者。进行统计学分析以阐明哪些胃癌危险因素对胃癌致癌性的影响最大。
在一项病例对照研究中，血清胃蛋白酶原I水平（优势比[OR]=1.81；95%置信区间[CI]，1.04 - 3.16）和胃蛋白酶原I/II比值（OR = 3.09；95% CI，1.74 - 5.49）与胃癌风险显著相关。抗H. pylori血清IgG抗体血清阳性（OR = 1.25；95% CI，0.84 - 1.85）和L-myc基因多态性的特定基因型（OR = 1.33；95% CI，0.59 - 2.99）在胃癌病例中更常见，但无统计学意义。CYP2E1 RsaI多态性和GSTM1基因缺失的特定基因型与胃癌无关。
血清胃蛋白酶原水平所表明的萎缩性黏膜改变可能是胃癌的一个危险因素。在本研究中，H. pylori感染以及CYP2E1、L-myc和GSTM1基因多态性不是危险因素。
