Gastric cancer: an infectious disease.

Gastric cancer: an infectious disease.
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DOI:
10.1016/j.idc.2010.07.010
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发表时间:
2010-12
影响因子:
4.4
通讯作者:
Correa P
Correa P
中科院分区:
医学3区
文献类型:
--
作者:
Piazuelo MB;Epplein M;Correa P

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尽管病毒和寄生虫因子与人类癌症有关,但胃癌是目前唯一被认为与细菌在人类中有因果关系的恶性肿瘤。1994年,国际癌症研究机构(IARC)得出结论:“有足够的证据表明幽门螺杆菌感染对人类具有致癌性”[1]。当时,他们得出结论,“在实验动物中没有足够的证据证明幽门螺杆菌感染的致癌性”。从那时起,致癌性的实验证据已被记录,特别是利用蒙古沙鼠模型[2]。2009年,IARC重新评估并确认了这些证据[3]。H.幽门螺杆菌与胃腺癌和胃粘膜相关淋巴组织(MALT)淋巴瘤的病因有关[3]。由于胃腺癌占所有胃恶性肿瘤的90%以上[4],因此本文将重点介绍胃腺癌。尽管在许多国家,胃癌的发病率一直在下降,但这种疾病是全球第二大常见癌症死亡原因,在全球癌症发病率中排名第四(表1)[5]。据估计,2007年约有100万新病例[6]。全世界人口之间胃癌发病率存在显著差异。发病率最高的是日本、韩国、中国、东欧和拉丁美洲的安第斯地区。非洲、大洋洲、北美洲和巴西的发病率较低(图1)。尽管美国胃癌发病率和死亡率总体较低,但仍有一些种族群体的风险增加,包括非洲裔美国人,美洲原住民以及来自东亚和拉丁美洲的移民[7-9]。此外,尽管美国胃癌的总体发病率一直在稳步下降,但最近一项基于美国国家癌症研究所监测、流行病学和终结研究中心数据的观察性研究表明,
Although viral and parasitic agents have been implicated in human cancers, gastric cancer is at the present time the only malignant neoplasia recognized as causally associated in humans with a bacterium. In 1994 the International Agency for Research on Cancer (IARC) concluded:“there is sufficient evidence in humans for the carcinogenicity of infection with Helicobacter pylori”[1]. At that time they concluded that “there is inadequate evidence in experimental animals for the carcinogenicity of infection with Helicobacter pylori”. Since then, experimental evidence of carcinogenicity has been documented, especially utilizing the Mongolian gerbil model [2]. In 2009 the evidence was reevaluated and confirmed by the IARC [3]. H. pylori is associated with causation of gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma [3]. Since gastric adenocarcinomas account for more than 90% of all gastric malignancies [4], this review will focus on adenocarcinomas.Although gastric cancer rates have been decreasing in many countries, this disease is the second most common cause of death from cancer worldwide and ranks fourth worldwide in cancer incidence (Table 1)[5]. Approximately one million new cases were estimated in 2007 [6]. There are marked differences in gastric cancer rates among populations worldwide. The highest incidence rates are in Japan, Korea, China, Eastern Europe and the Andean portions of Latin America. Lower rates are seen in Africa, Oceania, North America, and Brazil (Fig. 1). Despite the low overall rates in gastric cancer incidence and mortality in the United States, there are some ethnic groups at increased risk, including African Americans, Native Americans, and immigrants from East Asia and Latin America [7–9]. In addition, although overall incidence rates of gastric cancer have been steadily declining in the United States, a recent observational study based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End
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