HELICOBACTER-PYLORI INFECTION AND GASTRIC-CARCINOMA AMONG JAPANESE-AMERICANS IN HAWAII
HELICOBACTER-PYLORI INFECTION AND GASTRIC-CARCINOMA AMONG JAPANESE-AMERICANS IN HAWAII
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DOI：
10.1056/nejm199110173251604
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发表时间：
1991-10-17
影响因子：
158.5
通讯作者：
BLASER, MJ
中科院分区：
文献类型：
--
作者：
NOMURA, A;STEMMERMANN, GN;BLASER, MJ
背景。幽门螺杆菌是革兰氏阴性螺旋细菌，与慢性胃炎有关，慢性胃炎是胃癌的已知前体。胃癌高风险的人已显示出幽门螺杆菌感染的高患病率。我们研究了居住在夏威夷的日裔美国人中的幽门螺杆菌感染和胃癌的关系。从1967年到1970年，对5908名男性进行了检查。到1989年，已经确定了109例病理确认的胃癌病例。测试了每位患有胃癌和每个匹配对照受试者的患者储存的血清，以确保存在于幽门螺杆菌的血清IgG抗体。胃癌患者中有94％和76％的匹配对照受试者对幽门螺杆菌抗体进行了阳性测试，几率为6.0（95％的置信区间，2.1至17.3）。随着幽门螺杆菌抗体水平的增加，胃癌的风险逐渐增加（趋势= 0.0009）。即使对于在获得血清样本后10年或更长时间进行诊断的男性中，这种关联也很强（优势比为10.5; 95％的置信区间，2.5至44.8）。结论。幽门螺杆菌感染与胃癌的风险增加密切相关。但是，大多数感染幽门螺杆菌的人永远不会患有胃癌。因此，需要确定感染幽门螺杆菌的人群胃癌风险的其他因素。
Background. Helicobacter pylori are gram-negative spiral bacteria that are associated with chronic gastritis, a known precursor of gastric carcinoma. Persons at high risk for gastric carcinoma have been shown to have a high prevalence of H. pylori infection.Methods. We studied the relation of H. pylori infection and gastric carcinoma in a cohort of Japanese American men living in Hawaii. The 5908 men were enrolled and examined from 1967 to 1970. By 1989, 109 cases of pathologically confirmed gastric carcinoma had been identified. The stored serum of each patient with gastric carcinoma and of each matched control subject was tested for the presence of serum IgG antibody to H. pylori.Results. Ninety-four percent of the men with gastric carcinoma and 76 percent of the matched control subjects had a positive test for H. pylori antibodies, for an odds ratio of 6.0 (95 percent confidence interval, 2.1 to 17.3). As the level of antibody to H. pylori increased, there was a progressive increase in the risk of gastric carcinoma (P for trend = 0.0009). The association was strong even for men in whom the diagnosis was made 10 or more years after the serum sample was obtained (odds ratio, 10.5; 95 percent confidence interval, 2.5 to 44.8).Conclusions. Infection with H. pylori is strongly associated with an increased risk of gastric carcinoma. However, most persons infected with H. pylori will never have gastric carcinoma. Therefore, other factors that increase the risk of gastric carcinoma among persons infected with H. pylori need to be identified.