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首页> 外文期刊>International Journal of Cancer =: Journal International du Cancer >Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer
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Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer

机译：根据胃蛋白酶原和幽门螺杆菌抗体滴度的血清水平评估，基于慢性活动性胃炎和由此引起的胃萎缩的癌症发展

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摘要

Our study investigated the relationship between gastric cancer development and activity of Helicobacter pylori-associated chronic gastritis or the resulting chronic atrophic gastritis (CAG). A cohort of 4,655 healthy asymptomatic subjects, in whom serum pepsinogen (PG) and H. pylori antibody titer had been measured to assess the activity and stage of H. pylori-associated chronic gastritis, was followed for up to 16 years, and cancer development was investigated. In subjects with a serologically diagnosed healthy stomach (H. pylori-negative/CAG-negative), cancer incidence rate was low, at 16/100,000 person-years. With the establishment of H. pylori infection and progression of chronic gastritis, significant stepwise cancer risk elevations were seen from CAG-free subjects (H. pylori-positive/CAG-negative) [hazard ratio (HR) = 8.9, 95% confidence interval (CI) = 2.7-54.7] to subjects with CAG (H. pylori-positive/CAG-positive) (HR = 17.7, 95% CI = 5.4-108.6) and finally to subjects with metaplastic gastritis (H. pylori-negative/CAG-positive) (HR = 69.7, 95% CI = 13.6-502.9). In H. pylori-infected CAG-free subjects, significantly elevated cancer risk was observed in the subgroup with active inflammation-based high PG II level or potent immune response-based high H. pylori antibody titer; the former was associated with a particularly high risk of diffuse-type cancer, and both subgroups showed high cancer incidence rates of around 250/100,000 person-years, comparable to that in subjects with CAG. No such risk elevation was observed in H. pylori-infected subjects with CAG. These results clearly indicate that gastric cancer develops mainly from the gastritis-atrophy-metaplasia-cancer sequence and partly from active inflammation-based direct carcinogenesis, and that serum levels of PG and H. pylori antibody titer provide indices of cancer development in H. pylori-infected subjects. What's new? Infection with the bacteria H. pylori is the most common risk factor for developing gastric cancer. The infection causes chronic inflammation leading to a sequence of gastritis, atrophy, metaplasia, dysplasia, cancer. This study follows up a cohort of 6,000 men after 16 years and showed that cancer risk increased with the progression of inflammation and atrophy, which can be measured by serum tests. These tests, the authors suggest, would be useful in assessing risk among people infected with H. pylori.
机译：我们的研究调查了胃癌的发展与幽门螺杆菌相关的慢性胃炎或由此引起的慢性萎缩性胃炎（CAG）活性之间的关系。对4,655名健康无症状的受试者进行了长达16年的随访，其中研究者测定了血清胃蛋白酶原（PG）和幽门螺杆菌抗体滴度，以评估幽门螺杆菌相关的慢性胃炎的活性和分期，并随访了16年被调查了。经血清学诊断为健康胃（幽门螺杆菌阴性/ CAG阴性）的受试者，癌症发生率很低，为16 / 100,000人年。随着幽门螺杆菌感染的建立和慢性胃炎的进展，无CAG的受试者（幽门螺杆菌阳性/ CAG阴性）的患癌风险逐步升高[危险比（HR）= 8.9，置信区间为95％ （CI）= 2.7-54.7]接受CAG（幽门螺杆菌阳性/ CAG阳性）患者（HR = 17.7，95％CI = 5.4-108.6），最后接受化生性胃炎患者（H. pylori-阴性/ CAG阳性）（HR = 69.7，95％CI = 13.6-502.9）。在无幽门螺杆菌感染的无CAG的受试者中，在以炎症为基础的活跃的高PG II水平或以免疫反应为基础的高幽门螺杆菌抗体高滴度的亚组中观察到明显的癌症风险。前者与弥漫型癌症的患病风险特别高有关，并且两个亚组的癌症发生率均在250 / 100,000人年左右，与CAG患者相当。在幽门螺杆菌感染的CAG患者中未观察到这样的风险升高。这些结果清楚地表明，胃癌主要由胃炎-萎缩-间皮癌-癌序列发展，部分由基于主动炎症的直接癌变发展，并且血清PG和幽门螺杆菌抗体滴度提供了幽门螺杆菌癌症发展的指标。感染的受试者。什么是新的？幽门螺杆菌感染是发生胃癌的最常见危险因素。感染引起慢性炎症，导致一系列胃炎，萎缩，化生，发育异常，癌症。这项研究对16岁后的6,000名男性进行了随访，结果表明，随着发炎和萎缩的进展，癌症风险会增加，这可以通过血清测试来衡量。作者认为，这些测试对于评估幽门螺杆菌感染者的风险非常有用。

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