Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis
Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis
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DOI：
10.1007/s10620-010-1154-0
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发表时间：
2010-11-01
影响因子：
3.1
通讯作者：
Watanabe, Yoshiyuki
中科院分区：
文献类型：
--
作者：
Mizuno, Shigeto;Miki, Ikuya;Watanabe, Yoshiyuki
虽然通过X射线检查进行胃癌筛查已被证实可有效降低胃癌死亡率，但也有人指出其效率有所下降。建立有效的筛查体系，重点关注幽门螺杆菌感染和萎缩性胃炎等高危状况。迄今为止，血清抗幽门螺杆菌抗体和胃蛋白酶原测量的联合使用已在机会性和工作场所健康检查的参与者中进行了前瞻性评估；为了明确幽门螺杆菌感染和萎缩性胃炎导致胃癌的人群风险，在京都府乡镇进行了一项队列研究。研究对象为1987年健康检查中招募的1,011名男性和1,848名女性。对他们的血清进行了抗幽门螺杆菌抗体和胃蛋白酶原I和II的检测。胃癌病例是从这些城镇的癌症登记处进行评估的。截至1996年底，有33名男性和28名女性患上胃癌。通过 Cox 比例模型计算性别和年龄调整后的风险比。即使受试者没有萎缩，幽门螺杆菌感染也会增加患胃癌的风险（风险比 = 4.20；95% 置信区间，0.96-18.40）。当他们同时患有幽门螺杆菌感染和萎缩时，风险进一步增加（风险比 = 11.23；95% 置信区间，2.71-46.51）。患有萎缩但抗幽门螺杆菌抗体阴性的受试者风险最高（风险比=14.81；95%置信区间为2.47-88.80）。可通过血清学预筛查选择胃癌高危人群。
Though gastric cancer screening by X-ray examination has been confirmed to be effective for reducing gastric cancer mortality, decreases in efficiency have been pointed out. Establishment of an effective screening system, focusing on high-risk status such as Helicobacter pylori infection and atrophic gastritis, is desirable. To date, combined use of serum anti-Helicobacter pylori antibodies and pepsinogen measurement has been assessed prospectively in participants in opportunistic and workplace health check-ups; however, there are no reports of population-based cohort study.To clarify the population-based risk of Helicobacter pylori infection and atrophic gastritis for gastric cancer, a cohort study was conducted in rural towns in Kyoto Prefecture.Subjects were 1,011 males and 1,848 females recruited in a health check-up in 1987. Their serum was examined for anti-Helicobacter pylori antibodies and pepsinogen I and II. Gastric cancer cases were assessed from the cancer registry of those towns.Up to the end of 1996, 33 males and 28 females developed gastric cancer. A sex- and age-adjusted hazard ratio was calculated by Cox's proportional model. Helicobacter pylori infection increased the risk of gastric cancer even when the subjects had no atrophy (hazard ratio = 4.20; 95% confidence interval, 0.96-18.40). The risk increased further when they had both Helicobacter pylori infection and atrophy (hazard ratio = 11.23; 95% confidence interval, 2.71-46.51). Subjects with atrophy but negative for anti-Helicobacter pylori antibodies had the highest risk (hazard ratio = 14.81; 95% confidence interval, 2.47-88.80).A high-risk group for gastric cancer can be selected by serological prescreening.