Gastrin and colorectal cancer: A prospective study
Gastrin and colorectal cancer: A prospective study
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DOI：
10.1016/s0016-5085(98)70193-3
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发表时间：
1998-08-01
期刊：
影响因子：
29.4
通讯作者：
Parsonnet, J
中科院分区：
文献类型：
--
作者：
Thorburn, CM;Friedman, GD;Parsonnet, J
背景与目的：胃泌素是大肠癌的启动子。本研究的目的是评估胃泌素血症与结直肠恶性肿瘤发展之间的时间关系。研究方法：我们对128，992名健康维护计划的参与者进行了巢式病例对照研究，这些参与者在1964年至1969年期间参加了多阶段健康检查。自检查以来，血清一直被冷冻，并对癌症进行了随访。在1881例大肠癌病例中，随机选择250例，每个病例按年龄、性别、教育程度和血清采集日期匹配1例对照组。储存的血清进行测试幽门螺杆菌免疫球蛋白G和胃泌素和甘氨酸延长的胃泌素。结果：证实的病例包括166例结肠癌，58例直肠癌，9例两个部位的癌症。从血清收集到癌症诊断的平均时间为15.3年。病例组和对照组的中位胃泌素水平相似（41.7 vs 40.7 pg/mL）。然而，胃泌素水平高于正常值与结直肠恶性肿瘤风险增加相关（比值比，3.9; 95%可信区间，1.5-9.8）。如果这种关联是因果关系，那么8.6%的结直肠癌可归因于高血清胃泌素水平。结论：高胃泌素血症与结直肠癌风险增加有关。
Background & Aims: Gastrin is a putative promoter of colorectal carcinomas. The aim of this study was to evaluate the temporal relationship between gastrinemia and development of colorectal malignancy. Methods: We conducted a nested case-control study among 128,992 subscribers to a health maintenance program who had participated in a multiphasic health checkup between 1964 and 1969. Serum had been frozen since the checkup and the cohort followed up for cancer. Of 1881 incident colorectal carcinoma cases, 250 were randomly selected; 1 control without cancer was matched to each case by age, sex, education, and date of serum collection. Stored sera were tested for Helicobacter pylori immunoglobulin G and for gastrin and glycine-extended gastrin. Results: Verified cases included 166 colon cancers, 58 rectal cancers, and 9 with cancer in both locations. A mean of 15.3 years had elapsed between serum collection and diagnosis of cancer. Median gastrin levels were similar in cases and controls (41.7 vs. 40.7 pg/mL). However, a gastrin level above normal was associated with increased risk for colorectal malignancy (odds ratio, 3.9; 95% confidence interval, 1.5-9.8). If this association is causal, 8.6% of colorectal cancers could be attributed to high serum gastrin level. Conclusions: Hypergastrinemia is associated with an increased risk of colorectal carcinoma.