A CASE-CONTROL STUDY OF GASTRIC-CANCER AND DIET IN ITALY .3. RISK PATTERNS BY HISTOLOGIC TYPE
A CASE-CONTROL STUDY OF GASTRIC-CANCER AND DIET IN ITALY .3. RISK PATTERNS BY HISTOLOGIC TYPE
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DOI：
10.1002/ijc.2910480310
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发表时间：
1991-05-30
影响因子：
6.4
通讯作者：
BLOT, WJ
中科院分区：
文献类型：
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作者：
BUIATTI, E;PALLI, D;BLOT, WJ
在意大利的高风险和低风险地区进行的胃癌（GC）病例对照研究中，923例GC由一位病理学家根据Lauren分类法进行系统分类，区分2种主要组织学类型，肠型（55%）和弥漫型（23%）。 在该国中北部的高风险地区，肠道型的数量超过弥漫型的数量，比例为3比1，而在低风险地区，这两种类型的发生率几乎相等。 肠型也发生相对更频繁地在老年人和男性。 每种类型的GC的相对风险进行了评估，从癌症患者和对照组的访谈中获得的饮食和其他数据。 肠型和弥漫型的风险模式非常相似。 这两种类型的风险增加与肉类，咸鱼/干鱼，调味奶酪和传统汤的高摄入量有关，而在新鲜蔬菜和水果的重度消费者中发现这两种类型的风险降低。 相应地，在营养素指数中观察到类似的模式，肠道和弥漫性GC的风险随着动物蛋白摄入量的增加而增加，随着维生素C和E的摄入量的减少而下降。 这两种类型都与社会经济地位呈负相关，并且都与吸烟无关。 每种类型的患者比对照组更频繁地报告GC家族史，尽管最高风险是未分类的GC，一组低分化和髓样癌占本研究中所有GC的15%。 研究结果表明，尽管在地理和人口统计学模式的差异，肠道和弥漫型胃癌有共同的病因因素。
In a case-control study of gastric cancer (GC) in high-risk and low-risk areas of Italy, 923 GCs were systematically categorized by one pathologist according to the Lauren classification distinguishing 2 main histologic types, intestinal (55%) and diffuse (23%). Intestinal types outnumbered diffuse types by a 3 to 1 margin in high-risk regions in the north-central part of the country, while both types occurred at nearly equal rates in low-risk areas. Intestinal types also occurred relatively more frequently at older ages and among males. Relative risks of each type of GC were evaluated in relation to dietary and other data obtained from interviews with the cancer patients and controls. The risk patterns for intestinal and diffuse types were remarkably similar. Increased risks of both types were associated with high intake of meat, salted/dried fish, seasoned cheeses and traditional soups, while decreased risks of both types were found among heavy consumers of fresh vegetables and fruits. Correspondingly similar patterns were seen with indices of nutrients, with risks of both intestinal and diffuse GC rising with animal protein intake and declining with consumption of vitamins C and E. Both types were inversely related to socio-economic status, and neither was associated with cigarette smoking. A familial history of GC was reported more frequently by patients with each type than by controls, although the highest risk was for unclassified GC, a group of poorly differentiated and medullary carcinomas accounting for 15% of all GCs in this study. The findings suggest that, despite differences in geographic and demographic patterns, the intestinal and diffuse types of GC have etiologic factors in common.