HELICOBACTER-PYLORI INFECTION AND GASTRIC LYMPHOMA
HELICOBACTER-PYLORI INFECTION AND GASTRIC LYMPHOMA
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DOI：
10.1056/nejm199405053301803
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发表时间：
1994-05-05
影响因子：
158.5
通讯作者：
FRIEDMAN, GD
中科院分区：
文献类型：
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作者：
PARSONNET, J;HANSEN, S;FRIEDMAN, GD
背景：幽门螺杆菌感染是胃腺癌的危险因素。我们检查了这种感染是否也是原发性胃非霍奇金淋巴瘤的危险因素。方法。这项巢式病例对照研究涉及两个大型队列（230,593 名参与者）。从队列成员中收集并储存血清，并对所有受试者进行癌症跟踪。确定了 33 名胃非霍奇金淋巴瘤患者，根据队列、年龄、性别和血清采集日期将每名患者与 4 名对照进行匹配。为了进行比较，对来自其中一个队列的 31 名非胃非霍奇金淋巴瘤患者进行了评估，每名患者之前都与 2 名对照进行了匹配。检查病理报告和标本以确认肿瘤的组织学类型。通过酶联免疫吸附测定对所有受试者的血清样本进行幽门螺杆菌 IgG 检测。结果。 33 例胃非霍奇金淋巴瘤发生在血清采集后的中位时间为 14 年。胃淋巴瘤患者比匹配对照患者更有可能有既往幽门螺杆菌感染证据（匹配比值比，6.3；95% 置信区间，2.0 至 19.9）。两个队列的结果相似。在 31 名非胃淋巴瘤患者中，从血清采集到疾病发生之间的平均时间为 6 年。未发现非胃非霍奇金淋巴瘤与既往幽门螺杆菌感染之间存在关联（匹配比值比，1.2；95% 置信区间，0.5 至 3.0）。结论。影响胃但不影响其他部位的非霍奇金淋巴瘤与之前的幽门螺杆菌感染有关。该生物体的致病作用似乎是合理的，但尚未得到证实。
Background, Helicobacter pylori infection is a risk factor for gastric adenocarcinoma. We examined whether this infection is also a risk factor for primary gastric non-Hodgkin's lymphoma.Methods. This nested case-control study involved two large cohorts (230,593 participants). Serum had been collected from cohort members and stored, and all subjects were followed for cancer. Thirty-three patients with gastric non-Hodgkin's lymphoma were identified, and each was matched to four controls according to cohort, age, sex, and date of serum collection. For comparison, 31 patients with nongastric non-Hodgkin's lymphoma from one of the cohorts were evaluated, each of whom had ;been previously matched to 2 controls. Pathological reports and specimens were reviewed to confirm the histologic type of the tumor. Serum samples from all subjects were tested for H. pylori IgG by an enzyme-linked immunosorbent assay.Results. Thirty-three cases of gastric non-Hodgkin's lymphoma occurred a median of 14 years after serum collection. Patients with gastric lymphoma were significantly more likely than matched controls to have evidence of previous H. pylori infection (matched odds ratio, 6.3; 95 percent confidence interval, 2.0 to 19.9). The results were similar in both cohorts. Among the 31 patients with nongastric lymphoma, 8 median of six years had elapsed between serum collection and the development of disease. No association was found between nongastric non-Hodgkin's lymphoma and previous H. pylori infection (matched odds ratio, 1.2; 95 percent confidence interval, 0.5 to 3.0).Conclusions. Non-Hodgkin's lymphoma affecting the stomach, but not other sites, is associated with previous H. pylori infection. A causative role for the organism is plausible, but remains unproved.