Epidemiology of Helicobacter pylori and CagA-Positive Infections and Global Variations in Gastric Cancer.
Epidemiology of Helicobacter pylori and CagA-Positive Infections and Global Variations in Gastric Cancer.
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DOI：
10.3390/toxins10040163
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发表时间：
2018-04-19
期刊：
影响因子：
4.2
通讯作者：
Crabtree JE
中科院分区：
文献类型：
--
作者：
Park JY;Forman D;Waskito LA;Yamaoka Y;Crabtree JE
胃癌是一个主要的健康负担，是世界范围内第五大常见恶性肿瘤和第三大常见癌症死亡原因。胃癌的发生与宿主遗传、环境因素、幽门螺杆菌感染等因素有关。越来越多的流行病学研究表明，H。pylori感染及特异性毒力因子与胃癌的关系动物模型研究表明H.幽门螺杆菌是胃癌发生的主要因素。H. pylori是细胞毒素相关基因A（cagA），其编码cag致病岛中的CagA蛋白（cag派）。调查CagA血清阳性研究的荟萃分析，不考虑H。pylori感染者CagA血清学阳性与H. pylori感染者相比，胃癌发病风险增加（OR = 2.87，95% CI：1.95-4.22）。单纯pylori感染的OR = 2.31，95% CI：1.58-3.39。根除H.幽门螺杆菌是降低胃癌发病率的策略。一项对六项随机对照试验（RCT）的荟萃分析表明，寻找和根除H。pylori感染降低胃癌的发生率，合并相对危险度为0.66（95%CI：0.46-0.95）。在胃癌高发地区引入基于人群的H。幽门螺杆菌筛查和治疗计划，以及对计划过程、可行性、有效性和可能的不良后果的科学有效评估，将影响幽门螺杆菌的发病率。幽门诱发胃癌鉴于最近对CagA致癌作用的分子理解，靶向H.幽门螺杆菌高患病率人群的幽门螺杆菌筛查和治疗方案。pylori CagA阳性菌株，特别是致癌性更强的东亚H.幽门螺杆菌CagA菌株，可能值得进一步研究，以优化这些策略的好处。
Gastric cancer is a major health burden and is the fifth most common malignancy and the third most common cause of death from cancer worldwide. Development of gastric cancer involves several aspects, including host genetics, environmental factors, and Helicobacter pylori infection. There is increasing evidence from epidemiological studies of the association of H. pylori infection and specific virulence factors with gastric cancer. Studies in animal models indicate H. pylori is a primary factor in the development of gastric cancer. One major virulence factor in H. pylori is the cytotoxin-associated gene A (cagA), which encodes the CagA protein in the cag pathogenicity island (cag PAI). Meta-analysis of studies investigating CagA seropositivity irrespective of H. pylori status identified that CagA seropositivity increases the risk of gastric cancer (OR = 2.87, 95% CI: 1.95–4.22) relative to the risk of H. pylori infection alone (OR = 2.31, 95% CI: 1.58–3.39). Eradicating H. pylori is a strategy for reducing gastric cancer incidence. A meta-analysis of six randomised controlled trials (RCTs) suggests that searching for and eradicating H. pylori infection reduces the subsequent incidence of gastric cancer with a pooled relative risk of 0.66 (95% CI: 0.46–0.95). The introduction in regions of high gastric cancer incidence of population-based H. pylori screening and treatment programmes, with a scientifically valid assessment of programme processes, feasibility, effectiveness and possible adverse consequences, would impact the incidence of H. pylori-induced gastric cancer. Given the recent molecular understanding of the oncogenic role of CagA, targeting H. pylori screening and treatment programmes in populations with a high prevalence of H. pylori CagA-positive strains, particularly the more oncogenic East Asian H. pylori CagA strains, may be worth further investigation to optimise the benefits of such strategies.
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影响因子：
3.1
作者：
Gaddy, Jennifer A.;Radin, Jana N.;Cover, Timothy L.
通讯作者：
Cover, Timothy L.
影响因子：
3.4
作者：
CRABTREE, JE;COVACCI, A;RAPPUOLI, R
通讯作者：
RAPPUOLI, R
DOI：
10.1073/pnas.93.25.14648
发表时间：
1996-12-10
影响因子：
11.1
作者：
Censini, S;Lange, C;Covacci, A
通讯作者：
Covacci, A
影响因子：
11.2
作者：
Franco, Aime T.;Johnston, Elizabeth;Peek, Richard M., Jr.
通讯作者：
Peek, Richard M., Jr.
影响因子：
24.5
作者：
Colquhoun, A.;Arnold, M.;Soerjomataram, I.
通讯作者：
Soerjomataram, I.