Wu M S, Chen S Y, Shun C T, Lee W J, Wang H P, Wang T H, Chen C J, Lin J T
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
J Gastroenterol Hepatol. 1997 Jun;12(6):425-8. doi: 10.1111/j.1440-1746.1997.tb00460.x.
Previous data on the association of Helicobacter pylori infection with gastric cancer by demographic or histological features are inconsistent due to a univariate analysis of limited case numbers. The aim of the present study was to determine such an association by the use of a large series of patients and multiple variables analysis. The serum IgG antibodies against H. pylori were measured in 397 patients with histologically verified gastric cancer. A multiple logistic regression analysis was used to define the association between seropositivity and demographic or tumour characteristics of gastric cancer. The overall seropositivity of H. pylori was 63%. In univariate analysis, the prevalence was significantly lower among patients with cardia (50%) or diffuse-type (56.6%) cancers than those with non-cardia (64.8%) or intestinal-type (70.3%) cancer (P < 0.05 and P < 0.01, respectively). There was no statistical difference between H. pylori infection rate and gender, age or tumour stage. A multiple logistic regression analysis showed tumour location and histology remained significant factors associated with seropositivity of H. pylori with an odds ratio of approximately 2.0. Analysis of combined histology and location revealed that patients with intestinal-type cancer at non-cardia locations had the highest odds ratio of 3.93 (95% confidence interval (CI): 1.55-10.0) compared with the lowest odds ratio of 0.69 (95% CI: 0.30-1.62) in diffuse cardia cancer (P < 0.005). Our data indicate H. pylori infection in gastric cancer is independently affected by the histological subtype and by tumour location.
以往关于幽门螺杆菌感染与胃癌按人口统计学或组织学特征之间关联的数据，由于对有限病例数进行单变量分析而不一致。本研究的目的是通过使用大量患者和多变量分析来确定这种关联。对397例经组织学证实为胃癌的患者检测了抗幽门螺杆菌的血清IgG抗体。采用多因素logistic回归分析来确定血清阳性与胃癌的人口统计学或肿瘤特征之间的关联。幽门螺杆菌的总体血清阳性率为63%。在单变量分析中，贲门癌（50%）或弥漫型（56.6%）癌症患者的感染率显著低于非贲门癌（64.8%）或肠型（70.3%）癌症患者（P分别<0.05和P<0.01）。幽门螺杆菌感染率与性别、年龄或肿瘤分期之间无统计学差异。多因素logistic回归分析显示，肿瘤位置和组织学仍然是与幽门螺杆菌血清阳性相关的显著因素，优势比约为2.0。对组织学和位置进行联合分析发现，非贲门部位的肠型癌症患者的优势比最高，为3.93（95%置信区间（CI）：1.55 - 10.0），而弥漫型贲门癌的优势比最低，为0.69（95%CI：0.30 - 1.62）（P<0.005）。我们的数据表明，胃癌中的幽门螺杆菌感染独立地受组织学亚型和肿瘤位置的影响。
