Komoto K, Haruma K, Kamada T, Tanaka S, Yoshihara M, Sumii K, Kajiyama G, Talley N J
First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
Am J Gastroenterol. 1998 Aug;93(8):1271-6. doi: 10.1111/j.1572-0241.1998.00408.x.
Several authors have reported an association between Helicobacter pylori (H. pylori) and gastric carcinoma, but the data are conflicting. Atrophic gastritis and intestinal metaplasia (IM) have also been linked to gastric carcinoma, especially the intestinal tumor type. We investigated the relationship between H. pylori infection, gastric neoplasms, and histological gastritis.
A total of 105 patients with gastric carcinoma, 36 patients with gastric adenoma, and 105 age- and sex-matched control subjects were examined for H. pylori infection and histological gastritis. H. pylori status was evaluated by Giemsa staining and IgG serology. Mucosal inflammation, atrophy, and IM were evaluated in biopsy specimens from antrum and corpus.
H. pylori seroprevalence was higher in patients with gastric carcinoma (98 of 105, 93%) and adenoma (34 of 36, 94%) than in control subjects (82 of 105, 71%, p < 0.05). H. pylori was more prevalent in patients with noncardia (OR, 5.67; 95% CI, 2.25-14.44) than cardia (OR, 5.20; 95% CI, 0.65-41.68) tumors. Histologic types and tumor stage (early; OR, 6.60; 95% CI, 2.23-19.69, advanced; OR, 4.27; 95% CI, 1.21-15.03) showed no difference in H. pylori prevalence. Atrophy and IM scores were higher in patients with the intestinal- but not diffuse-type of carcinoma and adenoma than in H. pylori-positive control subjects. Smoking was associated with gastric carcinoma (OR, 3.05; 95% CI, 1.58-5.93) but not alcohol or coffee use, blood group A, or a family history of gastric cancer.
Our results confirm a strong association between H. pylori and gastric carcinoma and adenoma. The intestinal-type gastric carcinoma is associated with atrophic gastritis and IM.
多位作者报道了幽门螺杆菌（H. pylori）与胃癌之间存在关联，但数据存在冲突。萎缩性胃炎和肠化生（IM）也与胃癌相关，尤其是肠型肿瘤。我们研究了幽门螺杆菌感染、胃肿瘤与组织学胃炎之间的关系。
对105例胃癌患者、36例胃腺瘤患者以及105例年龄和性别匹配的对照者进行幽门螺杆菌感染和组织学胃炎检查。通过吉姆萨染色和IgG血清学评估幽门螺杆菌状态。对取自胃窦和胃体的活检标本评估黏膜炎症、萎缩和肠化生情况。
胃癌患者（105例中的98例，93%）和腺瘤患者（36例中的34例，94%）的幽门螺杆菌血清阳性率高于对照者（105例中的82例，71%，p < 0.05）。非贲门部肿瘤患者中幽门螺杆菌的患病率（比值比[OR]，5.67；95%置信区间[CI]，2.25 - 14.44）高于贲门部肿瘤患者（OR，5.20；95% CI，0.65 - 41.68）。组织学类型和肿瘤分期（早期；OR，6.60；95% CI，2.23 - 19.69，晚期；OR，4.27；95% CI，1.21 - 15.03）在幽门螺杆菌患病率方面无差异。肠型而非弥漫型的癌和腺瘤患者的萎缩和肠化生评分高于幽门螺杆菌阳性的对照者。吸烟与胃癌相关（OR，3.05；95% CI，1.58 - 5.93），但与饮酒、喝咖啡、血型A或胃癌家族史无关。
我们的结果证实了幽门螺杆菌与胃癌及腺瘤之间存在密切关联。肠型胃癌与萎缩性胃炎和肠化生相关。
