Barreto-Zuñiga R, Maruyama M, Kato Y, Aizu K, Ohta H, Takekoshi T, Bernal S F
Department of Gastroenterology, Mexico General Hospital, Mexico.
J Gastroenterol. 1997 Jun;32(3):289-94. doi: 10.1007/BF02934482.
We conducted a case-control study to examine the association of Helicobacter pylori infection as a risk factor in gastric cancer in the Japanese population. Serum IgG antibodies for Helicobacter pylori were determined in 55 consecutive patients with gastric cancer and in 75 age- and sex-matched mass survey subjects and 57 age- and sex-matched cancer-free patients with conditions considered at a high risk for development of gastric cancer (precancerous condition). We examined the histology in all subjects and particular focus was placed on the extent of Helicobacter pylori-associated gastritis. The seroprevalence of Helicobacter pylori in gastric cancer patients (82%) and those with a precancerous condition (89%) was significantly higher (P < 0.005) than that in the mass survey subjects (60%). Positive relative risk associations were found for patients with gastric cancer (odds ratio, 3, with 95% confidence intervals of 1.69-5.33) and those with a precancerous condition (odds ratio, 5.66, with 95% confidence intervals 2.66-12.03). Significant differences were found when comparisons were made among the case-control groups who were H. pylori-positive and had inflammatory cell infiltration (P = 0.0127). The characteristics of Helicobacter pylori in histologically examined gastric mucosa showed differences between Helicobacter pylori-infected and uninfected persons in all groups. However, for none of these groups was there a significant differences between background mucosa for Helicobacter pylori-infected persons with or without gastric cancer. Helicobacter pylori seroprevalence is strongly associated with an increased risk of gastric cancer and with a precancerous condition; histological investigation did not define additional factors that might be associated with increased cancer risk.
我们开展了一项病例对照研究，以检验幽门螺杆菌感染作为日本人群胃癌风险因素的相关性。对55例连续的胃癌患者、75例年龄和性别匹配的大规模调查对象以及57例年龄和性别匹配且患有被认为胃癌发生高风险疾病（癌前疾病）的无癌患者，测定了血清幽门螺杆菌IgG抗体。我们检查了所有受试者的组织学情况，并特别关注幽门螺杆菌相关性胃炎的程度。胃癌患者（82%）和癌前疾病患者（89%）的幽门螺杆菌血清阳性率显著高于大规模调查对象（60%）（P<0.005）。胃癌患者（比值比为3，95%置信区间为1.69 - 5.33）和癌前疾病患者（比值比为5.66，95%置信区间为2.66 - 12.03）存在正相对风险关联。在幽门螺杆菌阳性且有炎性细胞浸润的病例对照组之间进行比较时发现了显著差异（P = 0.0127）。在组织学检查的胃黏膜中，幽门螺杆菌的特征在所有组中显示出幽门螺杆菌感染和未感染人群之间存在差异。然而，对于这些组中的任何一组，感染幽门螺杆菌的有或无胃癌患者的背景黏膜之间均无显著差异。幽门螺杆菌血清阳性率与胃癌风险增加以及癌前疾病密切相关；组织学调查未确定可能与癌症风险增加相关的其他因素。
