Inoue M, Tajima K, Kobayashi S, Suzuki T, Matsuura A, Nakamura T, Shirai M, Nakamura S, Inuzuka K, Tominaga S
Division of Epidemiology, Aichi Cancer Center Hospital, Nagoya, Japan.
Int J Cancer. 1996 May 3;66(3):309-14. doi: 10.1002/(SICI)1097-0215(19960503)66:3<309::AID-IJC7>3.0.CO;2-2.
To investigate the association between atrophic gastritis and gastric cancer and to identify the risk and protective factors for the progression of atrophic gastritis to cancer, we conducted a prospective study on 5,373 subjects with neither cancer nor resected stomach who underwent gastroscopic examination and completed a life-style questionnaire. After an average of 6 years of follow-up, 69 gastric-cancer cases were identified, 65 from the subjects without atrophic gastritis and 4 from the subjects without atrophic gastritis. The presence of atrophic gastritis increased the risk of gastric cancer 2.19-fold, the risk trend increasing with the degree and the extension of atrophy [relative risk (RR) 1.60 for mild atrophy and 2.85 for moderate and severe atrophy]. Among the subjects with atrophic gastritis, family history of gastric cancer (RR 2.27) and a preference for spicy food (RR 1.84) increased the risk and self-administered meal controls, such as portion reduction (RR 0.44) reduction of salty food (RR 0.56) and the change to the consumption of easily digested food (RR 0.57) decreased the risk of gastric cancer. The results of this study suggest that atrophic gastritis increases the risk of gastric cancer but that dietary modification prevents the progression from atrophic gastritis to gastric cancer, regardless of pre-cancerous lesions.
为了研究萎缩性胃炎与胃癌之间的关联，并确定萎缩性胃炎进展为癌症的风险和保护因素，我们对5373名既无癌症也未接受过胃切除术的受试者进行了一项前瞻性研究，这些受试者接受了胃镜检查并完成了一份生活方式问卷。经过平均6年的随访，共确诊69例胃癌病例，其中65例来自无萎缩性胃炎的受试者，4例来自有萎缩性胃炎的受试者。萎缩性胃炎的存在使患胃癌的风险增加了2.19倍，风险趋势随着萎缩程度和范围的增加而增加[轻度萎缩的相对风险（RR）为1.60，中度和重度萎缩为2.85]。在患有萎缩性胃炎的受试者中，胃癌家族史（RR 2.27）和偏好辛辣食物（RR 1.84）会增加风险，而自我控制饮食，如减少食量（RR 0.44）、减少咸食摄入（RR 0.56）以及改为食用易消化食物（RR 0.57）则会降低患胃癌的风险。本研究结果表明，萎缩性胃炎会增加患胃癌的风险，但饮食调整可预防萎缩性胃炎进展为胃癌，无论是否存在癌前病变。
