Helicobacter pylori eradication for the prevention of gastric cancer
Helicobacter pylori eradication for the prevention of gastric cancer
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DOI：
10.1111/j.1478-405x.2006.00425.x
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发表时间：
2006-10-01
期刊：
影响因子：
4.4
通讯作者：
Sipponen, Pentti
中科院分区：
文献类型：
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作者：
Kuipers, Ernst J.;Sipponen, Pentti
尽管幽门螺杆菌感染是慢性非萎缩性和萎缩性胃炎以及胃发育不良和癌症的明显原因，但最近几项通过根除幽门螺杆菌预防胃癌的对照干预试验却取得了令人失望的结果。他们表明，在成功治疗幽门螺杆菌后，癌症根除的频率仍可能相对较高。对这一观察结果的一种解释是，幽门螺杆菌治疗对萎缩性胃炎胃癌发展的影响小于对非萎缩性胃炎癌症发展的影响，并且根除幽门螺杆菌治疗并不能阻止癌前病变和看不见的小早期癌症进展为明显的肿瘤。然而值得注意的是，现有的干预试验表明，对非萎缩性胃炎患者进行幽门螺杆菌治疗可以预防胃癌。需要对更多患者进行试验，进行更长的随访期，并更仔细地控制癌症类型和潜在的胃粘膜状况。
Even though Helicobacter pylori infection is an obvious cause of chronic nonatrophic and atrophic gastritis, as well as gastric dysplasia and cancer, several recent controlled intervention trials for the prevention of gastric cancer by H. pylori eradication have yielded disappointing results. They showed that cancer eradication may still appear in relatively high frequency after successful treatment of H. pylori. One explanation for this observation is that H. pylori treatment has less influence in development of gastric cancer in atrophic gastritis than in development of cancers in non-atrophic gastritis, and that eradication does not prevent the progression of precancerous lesions and small invisible early cancers to overt tumors. Noteworthy however, the available intervention trials show that gastric cancer can be prevented by H. pylori treatment in patients with non-atrophic gastritis. Trials with higher number of patients, with longer follow-up periods, and with more careful controlling of cancer type and underlying gastric mucosal conditions are needed.