Gastric precancerous process in a high risk population: cross-sectional studies.
Gastric precancerous process in a high risk population: cross-sectional studies.
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发表时间：
1990-08
期刊：
影响因子：
11.2
通讯作者：
P. Correa;W. Haenszel;C. Cuello;D. Zavala;E. Fontham;G. Zarama;S. Tannenbaum;T. Collazos;B. Ruiz
中科院分区：
文献类型：
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作者：
P. Correa;W. Haenszel;C. Cuello;D. Zavala;E. Fontham;G. Zarama;S. Tannenbaum;T. Collazos;B. Ruiz
在哥伦比亚纳里尼奥的一项胃镜调查中，对1788名参与者的胃癌前病变过程进行了评估，该地区是有史以来胃癌发病率最高的地区之一。使用详细的组织学分类，并描述了病变的分层分布，主要阶段为腺颈增生、萎缩（腺损失）、肠上皮化生和发育不良。急性炎症并不是该序列中的一个特定阶段，而是癌前谱所有阶段的共同发现。计算不同步骤的疾病进展指数，发现随着胃液pH值和硝酸盐和亚硝酸盐含量的增加而增加。高pH值和亚硝酸盐含量的影响密切相关。特定病变的相对风险，即增生、萎缩、化生和异型增生，随胃液pH值、硝酸盐和亚硝酸盐值的升高而线性增加。萎缩的严重程度与化生的患病率相关，表明所描述的阶段之间存在顺序关系，这一发现得到了所有检查参数的支持。所描述的进展模型可作为与不同胃癌风险水平的人群进行比较的基础，但它未能提供有关每次变化所需时间的信息，这些信息应通过随访（队列）研究提供。
The gastric precancerous process is evaluated in 1788 participants in a gastroscopy survey in the population of Nariño, Colombia, which has one of the highest gastric cancer incidence rates on record. A detailed histological classification is used, and a hierarchical distribution of lesions is described with the main stages being gland neck hyperplasia, atrophy (gland loss), intestinal metaplasia and dysplasia. Acute inflammation was not found to be a specific stage in the sequence but rather a common finding in all stages of the precancerous spectrum. Indices of disease progression for the different steps are calculated and found to increase with gastric pH and nitrate and nitrite content of the gastric juice. The effects of high pH and nitrite content are intimately correlated. Relative risks of specific lesions, namely, hyperplasia, atrophy, metaplasia, and dysplasia, increase linearly with higher pH, nitrate, and nitrite values in the gastric juice. The severity of atrophy correlates with the prevalence of metaplasia, suggesting a sequential relationship between the described stages, a finding supported by all parameters examined. The model of progression described may serve as a basis for comparisons with populations at different levels of gastric cancer risk but it fails to provide information concerning the time required for each change, which should be provided by follow-up (cohort) studies.