Seroepidemiological Study on Upper Gastrointestical Diseases

我们进行了一项血清流行病学巢式病例对照研究，以确定胃癌与幽门螺杆菌感染和萎缩性胃炎的关系。对2858名参与者进行了为期8年的年度多阶段健康检查。对45例胃癌患者和225例性别、年龄、住址相匹配的对照组进行数据分析。IgG抗体检测幽门螺杆菌感染，血清胃蛋白酶原I水平（<=70 ng/ml）及胃蛋白酶原I/II比值（<=3.0）诊断萎缩性胃炎。单因素分析显示幽门螺杆菌和萎缩性胃炎与胃癌有显著相关性。在多变量分析中，萎缩性胃炎与癌症风险显著增加相关（优势比为3.38；95%可信区间为1.54-7.42）；然而，幽门螺杆菌与癌症无关（优势比1.84；95%可信区间0.59-5.72）。采用Cox回归模型对胃癌与幽门螺杆菌感染和萎缩性胃炎的关系进行了血清流行病学研究。对2858名参与者进行了为期7.5年的年度多阶段健康检查。在研究结束时，参与者中有295人死亡，46人转移到其他地区，45人被诊断为胃癌。幽门螺杆菌感染和萎缩性胃炎的诊断方法与巢式病例对照研究相同。单因素分析显示幽门螺杆菌和萎缩性胃炎与胃癌有显著相关性。在多变量分析中，萎缩性胃炎与癌症风险显著增加相关（风险比4.01,95%可信区间1.94-8.29）；然而，幽门螺杆菌与癌症无关（风险比为1.56；95%可信区间为0.52-4.67）。这些结果提示单独幽门螺杆菌感染与胃癌发生无直接关系，但通过萎缩性胃炎的发生与胃癌发生有间接关系。少

We conducted a seroepidemiological nested case-control study to determine the association of gastric cancer with Helicobacter pylori infection and atrophic gastritis. A cohort of 2,858 participants in an annual multiphasic health check-up were followed for 8 years. Data for 45 gastric cancer cases and 225 sex, age and address matched control subjects were analyzed. Helicobacter pylori infecction was determined by IgG antibodies, and atrophic gastritis was diagnosed by both serum pepsinogen I level (<=70 ng/ml) and the pepsinogen I/II ratio (<=3.0). Univariate analysis showed that Helicobacter pylori and atrophic gastritis were significantly associated with gastric cancer. In a multivariate analysis, atrophic gastritis was associated with significantly increased risk of cancer (odds ratio, 3.38 ; 95% confidence interval, 1.54-7.42) ; however, Helicobacter pylori was not associated with cancer (odds ratio, 1.84 ; 95% confidence interval, 0.59-5.72). We also conducted a seroepidemiologica … More l cohort study using the Cox Regression model to determine the association of gastric cancer with Helicobacter pylori infection and atrophic gastritis. From a cohort of 2,858 participants in an annual multiphasic health check-up were followed for about 7.5 years. Among the participants, 295 were died, 46 moved to other areas and 45 were diagnosed as gastric cancer by the end of study period. Helicobacter pylori infection and atrophic gastritis were diagnosed by the same methods as nested case-control study. Univariate analysis showed that Helicobacter pylori and atrophic gastritis were significantly associated with gastric cancer. In a multivariate analysis, atrophic gastritis was associated with significantly increased risk of cancer (hazard ratio, 4.01 ; 95% confidence interval, 1.94-8.29) ; however, Helicobacter pylori was not associated with cancer (hazard ratio, 1.56 ; 95% confidence interval, 0.52-4.67). These results suggest that Helicobacter pylori infection alone is not directly associated with gastric carcinogenesis, but has an indirect relation to gastric cancer through the development of atrophic gastritis. Less