| 特集名 | Helicobacter pylori update | |
|---|---|---|
| 題名 | H. pylori抗体測定による胃がん検診は意義があるか | |
| 発刊年月 | 2005年 01月 | |
| 著者 | 笹島 雅彦 | 東邦大学医学部医学科内科学講座 (大森) 消化器内科 |
| 著者 | 瓜田 純久 | 東邦大学医学部医学科内科学講座 (大森) 消化器内科 |
| 著者 | 三木 一正 | 東邦大学医学部医学科内科学講座 (大森) 消化器内科 |
| 【 要旨 】 | Helicobacter pylori (H. pylori) は本邦における感染率が高いことから，H. pylori抗体の単独測定による胃がん検診を支持するエビデンスはない．しかし多くの施設から，H. pylori陽性者からの胃がん発生が多く，陰性者からは少ないことが報告されており，ペブシノゲン法と併せて受診者を胃がん高危険群，低危険群に分類することが検討されている． 現行の逐年X線胃がん検診を，リスクに応じて受診間隔を設定することで効率化することは有用であり，内視鏡検診にも応用が可能である．実施には測定キットの問題や年度を越えたデータ管理の煩雑さ，住民検診では個人情報の問題を解決する必要がある．今後，エビデンスの確立に向けて，多施設が共同して大規模な調査を行わなくてはならない． |
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| Theme | Helicobacter pylori update | |
|---|---|---|
| Title | Is Serum Helicobacter pylori IgG Antibody Test Useful for Gastric Cancer Screening? | |
| Author | Masahiko Sasajima | Division of Gastroenterology & Hepatology, Department of Internal Medicine (Oomori) School of Medicine, Faculty of Medicine Toho University |
| Author | Yoshihisa Urita | Division of Gastroenterology & Hepatology, Department of Internal Medicine (Oomori) School of Medicine, Faculty of Medicine Toho University |
| Author | Kazumasa Miki | Division of Gastroenterology & Hepatology, Department of Internal Medicine (Oomori) School of Medicine, Faculty of Medicine Toho University |
| [ Summary ] | Many previous studies have suggested that Helicobacter pylori (H. pylori) infection is a risk factor for gastric cancer. Long term surveillance of patients who have undergone gastric cancer screening, using gastric endoscopy and serum H. pylori-IgG antibody tests, suggested that the H. pylori-IgG antibody positive tests group constitutes a high risk group for gastric cancer and the negative group is a low risk group. On the other hand, we previously reported that the serum pepsinogen tests, as a primary screening tool for gastric cancer, are more cost effective than barium X-ray mass screening. Annual barium X-ray mass screening is conventional and useful in Japan, but many patients tend to dislike undergoing the barium X-ray mass screening. If we used the serum pepsinogen and H. pylori-IgG antibody tests as primary screening tools, we could manage barium X-ray mass screening more effectively. We propose a new method for gastric cancer screening : Only the high risk group, who are pepsinogen positive and H. pylori-IgG antibody positive should undergo annual barium X-ray mass screening, the low risk group, who are pepsinogen negative and H. pylori-IgG antibody negative, should undergo the barium X-ray mass screening at intervals of greater than a year. This strategy has not proven in practical terms, that a well designed epidemiological study is necessary to demonstrate the efficiency of this new method. |
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