幽门螺杆菌根除预防胃癌的发展——日本一项长期回顾性研究的结果

M. KATO, M. ASAKA, T. NAKAMURA, T. AZUMA, E. TOMITA, T. KAMOSHIDA, K. SATO, T. INABA, D. Shirasaka, S. OKAMOTO, S. TAKAHASHI, S. TERAO, K. SUWAKI, H. ISOMOTO, H. YAMAGATA, H. NOMURA, K. YAGI, Y. SONE, T. URABE, T. AKAMATSU, S. OHARA, A. TAKAGI, J. MIWA, S. INATSUCHI
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引用次数: 39

摘要

目的研究日本幽门螺杆菌(Helicobacter pylori)根除后胃癌的发病率。方法本研究是一项在日本23个中心进行的回顾性多中心研究。成功根除幽门螺杆菌和持续感染的患者如果连续5年每年至少进行一次上腔镜检查,则进入研究。在随访期间比较感染已成功根除者与持续幽门螺旋杆菌感染者胃癌的发生率。结果共纳入31000例患者。感染组的中位随访时间为7.7年,根除组为5.9年。成功根除幽门螺杆菌的患者中有23人(1%)发生胃癌,而持续幽门螺杆菌感染的患者中有44人(4%)发生胃癌(OR = 0.36;95% ci = 0.22-0.62)。结论在胃癌死亡率高的日本进行的这项大规模回顾性临床研究表明,根除幽门螺杆菌可以预防胃癌的发展。
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Helicobacter pylori eradication prevents the development of gastric cancer – results of a long-term retrospective study in Japan

Summary

Aim

This large-scale study was designed to investigate the incidence of gastric cancer after Helicobacter pylori (H. pylori) eradication in Japan.

Methods

This study was a retrospective multicentre study performed at 23 centres in Japan. Patients in whom H. pylori had been successfully eradicated and those in whom the infection persisted were entered into the study if they had undergone an upper endoscopic examination at least once a year for five consecutive years. The incidence rates of gastric cancer during follow-up were compared between those whose infections had been successfully eradicated and those with persistent H. pylori infection.

Results

Three-thousand twenty-one patients were enrolled. The median follow-up was 7.7 years for the infected group and 5.9 years for the eradicated group. Gastric cancer developed in 23 (1%) of those in whom H. pylori was successfully eradicated compared with 44 (4%) of those with persistent H. pylori infection (OR = 0.36; 95% CI = 0.22–0.62).

Conclusion

This large-scale retrospective clinical study in Japan, which has a high mortality rate for gastric cancer, indicates that H. pylori eradication may prevent the development of gastric cancer.

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