Effect of Helicobacter pylori infection combined with CagA and pepsinogen status on gastric cancer development among Japanese men and women:: A nested case-control study
Effect of Helicobacter pylori infection combined with CagA and pepsinogen status on gastric cancer development among Japanese men and women:: A nested case-control study
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DOI：
10.1158/1055-9965.epi-05-0901
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发表时间：
2006-07-01
影响因子：
3.8
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Sasazuki, Shizuka;Inoue, Manarni;Tsugane, Shoichiro
背景资料：虽然越来越多的证据表明，幽门螺杆菌在胃癌的发生中发挥了作用，风险的大小仍然不确定。目的：我们的目的是估计胃癌的风险与H。幽门螺杆菌感染的一项大型病例对照研究嵌套在一个前瞻性队列。CagA状态和血清胃蛋白酶原状态，作为萎缩性胃炎的标志物，可能的效果修改，也被认为是看到其对发展胃癌的影响。主题和方法：主题（n = 123,576）进行了随访，从1990年至2004年，511胃癌病例匹配511对照被用于分析。血浆抗H.结果：胃癌与H. pylori、CagA、胃蛋白酶原I和II相关的校正比值比（95%可信区间）为0. 05，与H. pylori感染率为5.1（3.2-8.0）。假设所有CagA阳性受试者都是真正的H。幽门螺杆菌阳性使这种风险加倍。萎缩性胃炎也与胃癌的风险增加和进一步增加与胃蛋白酶原level.Conclusions：胃蛋白酶原水平指示严重萎缩性胃炎的受试者可能需要定期仔细检查，无论H。幽门感染那些有其他胃蛋白酶原水平，但谁是H。pylori血清学阳性者可能受益于H.幽门根除治疗。考虑到使用多种血清学检测可能发生的费用和误分类的可能性，在解释或将这些结果外推到筛查策略中时需要谨慎。
Background: Although accumulating evidence suggests that Helicobacter pylori plays a role in gastric carcinogenesis, the magnitude of the risk remains uncertain.Aim: We aimed to estimate the magnitude of the risk of gastric cancer associated with H. pylori infection by a large case-control study nested within a prospective cohort. Possible effect modification by CagA status, and serum pepsinogen status, as a marker of atrophic gastritis, was also considered to see its effect on developing gastric cancer.Subjects and Methods: Subjects (n = 123,576) were followed up from 1990 to 2004; 511 gastric cancer cases matched to 511 controls were used in the analysis. Plasma immunoglobulin G antibody to H. pylori, CagA, and pepsinogen I and II were measured.Results: The adjusted odds ratio (95% confidence interval) of gastric cancer associated with H. pylori infection was 5.1 (3.2-8.0). Assuming all CagA-positive subjects are true H. pylori positives doubled this risk. Atrophic gastritis was also associated with an elevated risk of gastric cancer and the risk increased further with pepsinogen levels.Conclusions: Subjects with pepsinogen levels indicative of severe atrophic gastritis may need careful examination regularly regardless of H. pylori infection. Those who have other pepsinogen levels but who are H. pylori seropositive are likely to benefit from H. pylori eradication therapy. Considering both the cost and the potential for misclassification that may occur using multiple serologic tests, caution is needed in interpreting or extrapolating these findings into a screening strategy.