Shibata T, Imoto I, Ohuchi Y, Taguchi Y, Takaji S, Ikemura N, Nakao K, Shima T
Third Department of Internal Medicine, Mie University School of Medicine, Mie Prefecture, Japan.
Cancer. 1996 Mar 15;77(6):1044-9.
The discrepancy between the high seropositivity for Helicobacter pylori (H. pylori) and the low diagnostic yield of H. pylori organism in gastric biopsies of patients with gastric carcinoma has yet to be clarified. The present study attempted to clarify this controversial point by performing a comparative evaluation between the detection rate of H. pylori in biopsy and in surgical specimens.
The presence of H. pylori in biopsy samples from 50 patients with gastric carcinoma and 50 age-matched controls was evaluated histologically. Six histologic sections were obtained from gastric noncancerous areas and the presence of H. pylori was evaluated in those H. pylori negative patients who underwent gastrectomy.
H. pylori was positive in 35 of 50 controls (70%). In biopsy samples, H. pylori was detected in 29 of 37 patients (78.4%) with early gastric carcinoma, 7 of 13 (53.8%) with advanced carcinoma, 16 of 23 (69.6%) with intestinal type of gastric carcinoma, and 20 of 27 (74.1%) with diffuse type of carcinoma. Studies carried out in gastrectomy specimens increased the diagnostic yield of H. pylori to 33 (89.2%), 12 (92.3%), 19 (82.6%), and 26 (96.3%) in patients with early, advanced intestinal, and diffuse types of gastric carcinoma, respectively. Overall, H. pylori was positive in 36 biopsy specimens (72%) and 45 gastrectomy specimens (90%). Namely, the detection of H. pylori infection was significantly higher in patients with gastric carcinoma using gastrectomy specimens than in patients with gastric carcinoma using biopsy specimens only (P < 0.05).
These results indicate that the actual prevalence of H. pylori in patients with gastric carcinoma is considerably higher than that previously reported.
胃癌患者幽门螺杆菌（H. pylori）血清学阳性率高与胃活检中幽门螺杆菌的低诊断率之间的差异尚未明确。本研究试图通过对活检和手术标本中幽门螺杆菌的检出率进行比较评估来阐明这一有争议的问题。
对50例胃癌患者和50例年龄匹配的对照者的活检样本进行组织学评估，以检测幽门螺杆菌的存在。从胃非癌区域获取6个组织学切片，并对那些接受胃切除术的幽门螺杆菌阴性患者评估幽门螺杆菌的存在情况。
50例对照者中有35例（70%）幽门螺杆菌呈阳性。在活检样本中，早期胃癌患者37例中有29例（78.4%）检测到幽门螺杆菌，进展期癌患者13例中有7例（53.8%），肠型胃癌患者23例中有16例（69.6%），弥漫型癌患者27例中有20例（74.1%）。对胃切除标本进行的研究使早期、进展期肠型和弥漫型胃癌患者中幽门螺杆菌的诊断率分别提高到33例（89.2%）、12例（92.3%）、19例（82.6%）和26例（96.3%）。总体而言，36份活检标本（72%）和45份胃切除标本（90%）中幽门螺杆菌呈阳性。也就是说，使用胃切除标本的胃癌患者中幽门螺杆菌感染的检出率显著高于仅使用活检标本的胃癌患者（P < 0.05）。
这些结果表明，胃癌患者中幽门螺杆菌的实际患病率远高于先前报道的水平。
