Fifteen-Year Effects of Helicobacter pylori, Garlic, and Vitamin Treatments on Gastric Cancer Incidence and Mortality
Fifteen-Year Effects of Helicobacter pylori, Garlic, and Vitamin Treatments on Gastric Cancer Incidence and Mortality
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DOI：
10.1093/jnci/djs003
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发表时间：
2012-03-21
期刊：
影响因子：
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通讯作者：
Gail, Mitchell H.
中科院分区：
文献类型：
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作者：
Ma, Jun-Ling;Zhang, Lian;Gail, Mitchell H.
在山东干预试验中，幽门螺杆菌的2周抗生素治疗降低了胃癌前病变的患病率，而口服大蒜提取物和油（大蒜治疗）或维生素C，维生素E和硒（维生素治疗）的7.3年则没有。在这里，我们报告了在这项设盲的析因安慰剂对照试验中，对3365名随机分配的受试者进行的胃癌发病率和病因特异性死亡率的14.7年随访。条件Logistic回归用于估计胃癌发生的几率，考克斯比例风险模型用于估计病因特异性死亡率的相对风险。所有统计学检验均为双侧检验。接受幽门螺杆菌治疗的受试者中有3.0%被诊断为胃癌，而接受安慰剂治疗的受试者中有4.6%被诊断为胃癌（比值比= 0.61，95%置信区间= 0.38至0.96，P = 0.032）。1.5%的H pylon治疗组受试者和2.1%的安慰剂组受试者发生胃癌死亡（死亡风险比[HR]= 0.67，95% CI = 0.36 - 1.28）。大蒜和维生素治疗与胃癌发病率和死亡率的非统计学显著降低相关。维生素治疗与胃癌或食管癌死亡率（次要终点）统计学显著降低相关（HR = 0.51，95% CI = 0.30 - 0.87; P = 0.014）。
In the Shandong Intervention Trial, 2 weeks of antibiotic treatment for Helicobacter pylori reduced the prevalence of precancerous gastric lesions, whereas 7.3 years of oral supplementation with garlic extract and oil (garlic treatment) or vitamin C, vitamin E, and selenium (vitamin treatment) did not. Here we report 14.7-year follow-up for gastric cancer incidence and cause-specific mortality among 3365 randomly assigned subjects in this masked factorial placebo-controlled trial. Conditional logistic regression was used to estimate the odds of gastric cancer incidence, and the Cox proportional hazards model was used to estimate the relative hazard of cause-specific mortality. All statistical tests were two-sided. Gastric cancer was diagnosed in 3.0% of subjects who received H pylori treatment and in 4.6% of those who received placebo (odds ratio = 0.61, 95% confidence interval = 0.38 to 0.96, P = .032). Gastric cancer deaths occurred among 1.5% of subjects assigned H pylon treatment and among 2.1% of those assigned placebo (hazard ratio [HR] of death = 0.67, 95% CI = 0.36 to 1.28). Garlic and vitamin treatments were associated with non-statistically significant reductions in gastric cancer incidence and mortality. Vitamin treatment was associated with statistically significantly fewer deaths from gastric or esophageal cancer, a secondary endpoint (HR = 0.51, 95% CI = 0.30 to 0.87; P = .014).