Helicobacter pylori infection and the risks of Barrett's oesophagus: a population-based case-control study.
Helicobacter pylori infection and the risks of Barrett's oesophagus: a population-based case-control study.
复制标题
DOI：
10.1002/ijc.26242
复制
发表时间：
2012-05-15
影响因子：
6.4
通讯作者：
Whiteman, David C.
中科院分区：
文献类型：
--
作者：
Thrift, Aaron P.;Pandeya, Nirmala;Smith, Kylie J.;Green, Adele C.;Hayward, Nicholas K.;Webb, Penelope M.;Whiteman, David C.
关键词：
幽门螺杆菌感染与食管腺癌的风险显著降低相关，然而很少有研究检查幽门螺杆菌与Barrett食管（BO）（前体病变）之间的关联。我们探讨了幽门螺杆菌感染和BO之间的关系，并试图确定潜在的修饰剂。我们比较了217例单纯性BO（无异型增生）成人、95例异型增生BO和398例来自大都市布里斯班地区的对照人群中幽门螺杆菌血清学阳性的患病率。我们用酶联免疫吸附试验测定幽门螺杆菌血清状态。为了估计相对风险，我们在整个样本中使用多变量逻辑回归计算比值比（OR）和95%置信区间（CI），并按已知导致BO的因素分层。单纯性BO、异型增生BO和对照人群中幽门螺杆菌血清阳性率分别为12%、3%和18%。与人群对照相比，BO患者具有幽门螺杆菌抗体的可能性显著降低（单纯BO：OR = 0.51，95% CI：0.30 - 0.86;发育不良BO：OR = 0.10，95% CI：0.03 - 0.33）。对于单纯BO，在调整胃食管反流（戈尔）症状频率后，相关性减弱。调整戈尔症状的频率并没有实质上改变观察到的发育不良BO的影响。虽然在年龄、性别、戈尔症状和PPI或H2受体拮抗剂使用的分层中，风险估计值的大小存在一些差异，但差异均不显著。幽门螺杆菌感染与BO呈负相关，我们的研究结果表明，降低酸负荷不是幽门螺杆菌保护作用的唯一机制。
Infection with Helicobacter pylori is associated with significantly reduced risks of oesophageal adenocarcinoma, however few studies have examined the association between H pylori and Barrett's oesophagus (BO), the precursor lesion. We explored the relationship between H pylori infection and BO and sought to identify potential modifiers. We compared the prevalence of positive H pylori serology among 217 adults with simple BO (without dysplasia), 95 with dysplastic BO and 398 population controls sourced from the metropolitan Brisbane area. We determined H pylori serostatus using enzyme-linked immunosorbent assay. To estimate relative risks, we calculated odds ratios (OR) and 95% confidence intervals (CI) using multivariable logistic regression in the entire sample and stratified by factors known to cause BO. The prevalence of H pylori seropositivity was 12%, 3% and 18% respectively, among patients with simple BO, dysplastic BO and population controls. BO patients were significantly less likely to have antibodies for H pylori (Simple BO: OR=0.51, 95% CI: 0.30-0.86; Dysplastic BO: OR=0.10, 95% CI: 0.03-0.33) than population controls. For simple BO, the association was diminished after adjustment for frequency of gastro-oesophageal reflux (GOR) symptoms. Adjustment for frequency of GOR symptoms did not substantially alter the observed effect for dysplastic BO. While there was some variation in the magnitude of risk estimates across strata of age, sex, GOR symptoms, and use of PPIs or H2-receptor antagonists, the differences were uniformly nonsignificant. H pylori infection is inversely associated with BO, and our findings suggest that decreased acid load is not the only mechanism underlying the H pylori protective effect.
登录
查看更多内容
影响因子：
29.4
作者：
Huang, JQ;Sridhar, S;Hunt, RH
通讯作者：
Hunt, RH
DOI：
10.1111/j.1440-1746.2008.05415.x
发表时间：
2008-12-01
影响因子：
4.1
作者：
Jang, Eun Jeong;Park, Sang Woon;Baik, Hyun Wook
通讯作者：
Baik, Hyun Wook
影响因子：
3.2
作者：
Jones, AD;Bacon, KD;Rutten, MJ
通讯作者：
Rutten, MJ
DOI：
10.1093/jnci/djn211
发表时间：
2008-08-20
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Brown LM;Devesa SS;Chow WH
通讯作者：
Chow WH
影响因子：
29.4
作者：
CAMERON, AJ;LOMBOY, CT
通讯作者：
LOMBOY, CT