Risk of gastric cancer in the second decade of follow-up after Helicobacter pylori eradication
Risk of gastric cancer in the second decade of follow-up after Helicobacter pylori eradication
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DOI：
10.1007/s00535-019-01639-w
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发表时间：
2020-03-01
影响因子：
6.3
通讯作者：
Okada, Hiroyuki
中科院分区：
文献类型：
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作者：
Take, Susumu;Mizuno, Motowo;Okada, Hiroyuki
背景和目的根除幽门螺杆菌可降低胃癌的风险。在这项研究中，我们调查了根除H.方法我们对2737例幽门螺杆菌治愈后每年进行内镜随访的患者进行了回顾性队列研究。幽门感染为了比较第二个十年随访与第一个十年随访的胃癌风险，结果在长达21.4年的随访中，胃癌的发病率与年龄的比值（10 ~ 20岁）呈负相关（P < 0.05），而与年龄的比值（P < 0.05）呈负相关（P < 0.05），与年龄的比值（P < 0.05）呈负相关（P < 0.05）。胃癌发生率为0.35%（68/年）。弥漫型胃癌的SIRs为无穷大（0例预期病例和4例观察病例）轻度胃粘膜萎缩患者和10.9（95%置信区间4.53-26.1）中度萎缩，而无论基线胃萎缩的程度如何，在胃肠道型癌中均未观察到SIRs的显著增加，结论：随访时间越长，基线时轻度至中度胃萎缩患者发生弥漫型胃癌的风险越大。内镜监测应持续到H治愈后10年以上。pylori，无论胃萎缩的严重程度如何。
Background and aimsEradication of Helicobacter pylori reduces the risk of gastric cancer. In this study, we investigated the risk beyond 10 years after eradication of H. pylori.MethodsWe conducted a retrospective cohort study of 2737 patients who had yearly endoscopic follow-up after cure of H. pylori infection. For comparison of gastric cancer risk in the second decade of follow-up with that in the first decade, we calculated standardized incidence ratios (SIRs) by dividing the number of observed cases of gastric cancer in the second decade of follow-up by that of expected cases which was estimated using the incidence rate ratio of age in the first decade.ResultsDuring the follow-up for as long as 21.4 years (mean 7.1 years), gastric cancer developed in 68 patients (0.35% per year). The SIRs for diffuse-type gastric cancer was infinity (0 expected case and 4 observed cases) in patients with mild gastric mucosal atrophy and 10.9 (95% confidence interval 4.53-26.1) with moderate atrophy, whereas no significant increase of SIRs was observed in intestinal-type cancer regardless of the grade of baseline gastric atrophy or in diffuse-type cancer in patients with severe atrophy even though who had the highest risk.ConclusionsThe longer the follow-up, the greater the risk of developing diffuse-type gastric cancer becomes in patients with mild-to-moderate gastric atrophy at baseline. Endoscopic surveillance should be continued beyond 10 years after cure of H. pylori irrespective of the severity of gastric atrophy.