Association of Helicobacter pylori infection and environmental factors in non-cardia gastric cancer in Japan.
Association of Helicobacter pylori infection and environmental factors in non-cardia gastric cancer in Japan.
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DOI：
10.1007/s10120-004-0268-5
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发表时间：
2004-01-01
期刊：
影响因子：
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通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
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作者：
Machida-Montani, Ai;Sasazuki, Shizuka;Tsugane, Shoichiro
背景：虽然幽门螺杆菌感染是胃癌的主要危险因素，但它并不能解释胃癌发生的全貌。然而，很少有流行病学研究同时检查幽门螺杆菌和环境因素。本研究的目的是在考虑幽门螺杆菌感染的情况下，评估环境因素(吸烟和饮食因素)与胃癌的关系，并调查环境因素与幽门螺杆菌感染之间的相互作用。方法：1998年10月至2002年3月，在日本长野县的四家医院进行了一项多中心、以医院为基础的病例对照研究。对于153例新诊断的胃癌患者，从同一时期在同一医院进行健康体检的参与者中随机选择两个年龄(3年内)、性别和居住地相匹配的对照组。我们进行了问卷调查，并采集了血样。结果：122例非贲门癌患者和235例对照可用于本研究。在调整可能的混杂因素后，幽门螺杆菌感染与非贲门癌密切相关(优势比[OR]，8.2；95%可信区间[CI]，3.7-18.2)。即使在调整了可能的混杂因素，包括幽门螺杆菌感染后，吸烟(OR，2.8；95%CI，1.2~6.5)和经常食用酱油(OR，2.1；95%CI，0.9~5.1)和米饭(OR，2.5；95%CI，1.0~6.1)仍被确定为危险因素。然而，环境因素与幽门螺杆菌感染之间的交互作用没有统计学意义。结论：这一发现表明，尽管幽门螺杆菌感染明显是胃癌的重要危险因素，但在日本，戒烟和改变饮食可能是预防幽门螺杆菌阳性和阴性的非贲门型胃癌的实用策略。
BACKGROUND: Although Helicobacter pylori infection is a major risk factor for gastric cancer, it does not explain the full picture of stomach carcinogenesis. There have been few epidemiological studies, however, which examined both H. pylori and environmental factors simultaneously. The aims of this study were to estimate the association of environmental factors (smoking and dietary factors) with gastric cancer in consideration of H. pylori infection, and to investigate the effects of the interaction between environmental factors and H. pylori infection.METHODS: A multicenter, hospital-based, case-control study of gastric cancer was conducted at four hospitals in Nagano prefecture, Japan, between October 1998 and March 2002. For 153 newly diagnosed gastric cancer cases, two controls matched by age (within 3 years), sex, and residence area were randomly selected from the participants of a health check-up program during the same period in the same hospitals. We conducted a questionnaire survey and obtained blood samples. Consequently, 122 non-cardia gastric cancer cases and 235 controls were available for this analysis.RESULTS: Results. H. pylori infection was strongly associated with non-cardia gastric cancer after adjustment for possible confounding factors (odds ratio [OR], 8.2; 95% confidence interval [CI], 3.7-18.2). Cigarette smoking (OR, 2.8; 95% CI, 1.2-6.5) and frequent intake of miso (fermented soy bean) soup (OR, 2.1; 95% CI, 0.9-5.1) and rice (OR, 2.5; 95% CI, 1.0-6.1) were determined to be risk factors even after adjusting for possible confounding factors, including H. pylori infection. However, no statistically significant interaction between environmental factors and H. pylori infection was detected.CONCLUSION: This finding suggests that although H. pylori infection is clearly an important risk factor for gastric cancer, smoking cessation and dietary modification may be practical strategies for the prevention of non-cardia gastric cancer among both H. pylori-positive and -negative subjects in Japan.