The effect of Helicobacter pylori eradication on reducing the incidence of gastric cancer
The effect of Helicobacter pylori eradication on reducing the incidence of gastric cancer
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DOI：
10.1097/01.mcg.0000248006.80699.7f
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发表时间：
2008-03-01
影响因子：
2.9
通讯作者：
Omata, Masao
中科院分区：
文献类型：
--
作者：
Ogura, Keiji;Hirata, Yoshihiro;Omata, Masao
在流行病学上，慢性幽门螺杆菌感染与胃癌发生之间的关系已得到充分证实。虽然通过根除H.幽门螺杆菌感染最近由几个研究小组进行了调查，结果仍然存在争议。本研究的目的是确定根除H. pylori感染可降低胃癌的发病率。304例持续H. pylori感染和404例H.幽门螺杆菌感染根除者每年进行一次胃镜检查。第一组平均3.1年，第二组平均3.2年，分别有13名和6名患者被诊断为新发胃癌。两组之间胃癌的累积发病率存在统计学差异（P = 0.019;对数秩检验）。H.经考克斯比例风险模型分析，幽门螺杆菌根除率为0.335（P = 0.047）。在持续感染组中有11例患者发现分化型胃癌，在根除组中有3例患者发现分化型胃癌。两组间分化癌的发生率有显著差异（P = 0.017），但未分化癌的发生率无显著差异（P = 0.847）。目前的研究结果表明。根除H.幽门螺杆菌感染可降低胃癌的发病率。
Epidemiologically, the association between chronic Helicobacter pylori infection and development of gastric cancer is well established. Although the possibility of preventing gastric cancer by eradicating H. pylori infection was recently investigated by several research groups, the results remain controversial. The aim of this study was to determine whether the eradication of H. pylori infection would reduce the incidence of gastric cancer. In total, 304 patients with persistent H. pylori infection and 404 patients with H. pylori infection eradicated were examined annually for gastric cancer by endoscopy. Over an average of 3.1 years for the first group and 3.2 years for the second group, 13 and 6 patients, respectively, were diagnosed as having new gastric cancer. The cumulative incidence of gastric cancer was statistically different between the groups (P = 0.019; log-rank test). The hazard ratio of H. pylori eradication was 0.335 by Cox proportional hazards model (P = 0.047). Differentiated gastric cancer was found in I I patients in the persistent infection group and 3 patients in the eradicated group. The incidence of differentiated cancer was significantly different (P = 0.017) between the groups, but not for undifferentiated cancer (P = 0.847). The results of the current study suggest. that the eradication of H. pylori infection reduces the incidence of gastric cancer.