Thorburn C M, Friedman G D, Dickinson C J, Vogelman J H, Orentreich N, Parsonnet J
Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Gastroenterology. 1998 Aug;115(2):275-80. doi: 10.1016/s0016-5085(98)70193-3.
BACKGROUND & AIMS: Gastrin is a putative promoter of colorectal carcinomas. The aim of this study was to evaluate the temporal relationship between gastrinemia and development of colorectal malignancy.
We conducted a nested case-control study among 128,992 subscribers to a health maintenance program who had participated in a multiphasic health checkup between 1964 and 1969. Serum had been frozen since the checkup and the cohort followed up for cancer. Of 1881 incident colorectal carcinoma cases, 250 were randomly selected; 1 control without cancer was matched to each case by age, sex, education, and date of serum collection. Stored sera were tested for Helicobacter pylori immunoglobulin G and for gastrin and glycine-extended gastrin.
Verified cases included 166 colon cancers, 58 rectal cancers, and 9 with cancer in both locations. A mean of 15.3 years had elapsed between serum collection and diagnosis of cancer. Median gastrin levels were similar in cases and controls (41.7 vs. 40.7 pg/mL). However, a gastrin level above normal was associated with increased risk for colorectal malignancy (odds ratio, 3.9; 95% confidence interval, 1.5-9.8). If this association is causal, 8.6% of colorectal cancers could be attributed to high serum gastrin level.
Hypergastrinemia is associated with an increased risk of colorectal carcinoma.
胃泌素被认为是结直肠癌的促进因子。本研究旨在评估胃泌素血症与结直肠恶性肿瘤发生之间的时间关系。
我们在128,992名参加了1964年至1969年多阶段健康检查的健康维护计划订阅者中进行了一项巢式病例对照研究。自检查以来血清一直被冷冻保存，对该队列进行癌症随访。在1881例新发结直肠癌病例中，随机选择250例；按照年龄、性别、教育程度和血清采集日期为每例病例匹配1名无癌症的对照。对储存的血清检测幽门螺杆菌免疫球蛋白G、胃泌素和甘氨酸延伸胃泌素。
确诊病例包括166例结肠癌、58例直肠癌和9例两处均患癌者。从血清采集到癌症诊断平均经过了15.3年。病例组和对照组的胃泌素水平中位数相似（41.7对40.7 pg/mL）。然而，胃泌素水平高于正常与结直肠恶性肿瘤风险增加相关（比值比，3.9；95%置信区间，1.5 - 9.8）。如果这种关联是因果关系，8.6%的结直肠癌可归因于高血清胃泌素水平。
高胃泌素血症与结直肠癌风险增加相关。
