Risk of Cancer Onset in Sub-Saharan Africans Affected with Chronic Gastrointestinal Parasitic Diseases
Risk of Cancer Onset in Sub-Saharan Africans Affected with Chronic Gastrointestinal Parasitic Diseases
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受慢性胃肠道寄生虫病影响的撒哈拉以南非洲人患癌症的风险
DOI：
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发表时间：
2005
影响因子：
3.5
通讯作者：
P. Innocenti
中科院分区：
文献类型：
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作者：
M. Waku;L. Napolitano;E. Clementini;T. Staniscia;C. Spagnolli;A. Andama;P. Kasiriye;P. Innocenti
胃肠道血吸虫病和阿米巴病在西方世界并不常见，而这类感染在非洲社区却很常见。除了与这些寄生虫感染的临床症状相关的问题外，重要的是要强调胃肠道癌症的增加。在这项研究中，我们评估了由上述寄生虫引起的慢性炎症性疾病患者的癌症患病率。在2000年1月至2003年12月的三年中，我们共观察了1199名受试者。其中，950人出现腹泻、呕吐、腹痛、黑黑、呕血、直肠分泌物和排便习惯改变等症状。乌干达（穆拉戈和阿鲁阿医院）共有818名患者接受了评估，津巴布韦Luisa Guidotti医院共有381名患者接受了评估。收集每位患者详尽的临床病史，然后进行体格和实验室检查。我们获得了以前在各自医院住院的所有患者的临床档案，然后将这些档案中的信息与我们的临床研究结果相结合。经检查无胃肠道疾病，无胃肠道感染性疾病临床病史，但有其他病理表现者作为对照组。对照组249人。检查呈阳性的受试者接受进一步调查。血吸虫病221例，阿米巴病224例。有特异性小肠结肠炎454例，有肠结核21例，食管念珠菌病30例。然后将患有上述胃肠道疾病的患者分为3组。第一组患者有消化道感染性疾病的临床病史，因类似症状再次入院，检查结果为相同消化道感染性疾病阳性。这些患者被放置在“慢性组”。第二组是以前接受过感染性胃肠道疾病治疗但再次入院时发现没有感染性胃肠道疾病的患者，这一组被称为“治愈组”。他们有与其他病理相关的症状。第三组，我们称之为“急性组”，由以前没有任何胃肠道感染病例且首次入院的患者组成。这些患者在感染性胃肠道疾病检查中呈阳性。在950名患者中，我们总共发现了45个肿瘤。慢性组肿瘤发生率高（42例）。34例肿瘤位于结直肠，3例位于胃，4例位于食道，1例位于小肠。我们的研究结果表明，胃肠道慢性感染与发展肿瘤的可能性之间存在很强的联系。然而，目前尚不清楚这种转变涉及哪些生物机制。它们可能取决于允许致癌物质进入的胃肠道粘膜的慢性炎症，或者取决于寄生虫产生的致突变产物的作用，或者两者兼而有之。
Gastrointestinal Schistosomiasis and Amebiasis are uncommon in the western world, while such infections are frequent in the African community. In addition to the problems associated with the clinical symptoms of these parasitic infections, it is important to stress the increase in cancer of the Gastro-Intestinal (GI) tract. In this study we evaluate the prevalence of cancer in patients affected by chronic inflammatory diseases caused by the above named parasites. In three years, from January 2000 to December 2003, we observed a total of 1199 subject. Of these, 950 presented with complaints of diarrhoea, vomiting, abdominal pain, melena, hematemesis, rectal discharges and alteration of bowel habits. A total of 818 patients were evaluated in Uganda (Mulago and Arua hospitals) and 381 at Luisa Guidotti Hospital in Zimbabwe. An exhaustive clinical history was collected for each patient and then physical and laboratory examinations were performed. The clinical files of all patients previously admitted to the respective hospitals were obtained and the information taken from these files was then integrated with our clinical findings. Subjects who were found free of gastro-intestinal disease after examinations and did not have a clinical history of infective GI disease but presented with other pathologies, were regarded as control group. The control group was composed of 249 subjects. The subjects who were positive on examination underwent further investigations. The number of patients affected by schistosomiasis and amoebiasis were 221 and 224 respectivelly. The number of patients who suffered from aspecific enterocolitis was 454, intestinal tuberculosis was present in 21 patients and we found 30 patients with esophageal candidiasis. Patients who had the above mentioned GI diseases were then divided into 3 groups. First group was composed of patients who had a clinical history of infective GI diseases and were re-admitted for similar symptoms, and on examination were positive for the presence of the same infective GI diseases. Such patients were placed in the “Chronic group”. The second group was formed of patients who had previously undergone treatment for infective GI diseases but on re-admission were found free of infective GI disease, and this group was described as the “Cured group”. They had symptoms associated with other pathologies. A third group, which we described as the “Acute group” was composed of patients who did not have any previous case of GI infection and were admitted for the first time. Such patients were found positive on examination for infective GI diseases. In the 950 patients, we found a total of 45 tumors. The tumors were prevalent (42 tumours) in the chronic group. In 34 patients the tumor was in the colo-rectal region, in 3 patients in the stomach, in 4 patients in the oesophagus and 1 patient had cancer in the small bowel. Our results show a strong association between the chronic infection of the GI tract and the likelihood to develop tumours. However, it is not clear which biological mechanisms are implicated in such transformations. They may depend on the chronic inflammation of the GI mucous which permits the entrance of carcinogenic materials or on the effects of mutagenic products produced by the parasites or both.
影响因子：
3.7
作者：
Itzkowitz, SH
通讯作者：
Itzkowitz, SH