臨牀消化器内科 Vol.21 No.8(2-1)


特集名 H. pylori陰性胃癌の成因を探る
題名 生活習慣と胃癌 (1) 食塩と胃癌
発刊年月 2006年 07月
著者 溝下 勤 愛知県がんセンター研究所・腫瘍病理学部
著者 塚本 徹哉 愛知県がんセンター研究所・腫瘍病理学部
著者 立松 正衛 愛知県がんセンター研究所・腫瘍病理学部
【 要旨 】 食塩は,Helicobacter pylori (H. pylori) 感染スナネズミ腺胃で,用量依存的に胃発癌を促進した.食塩単独の胃発癌に対するプロモーター作用は,H. pyloriと比較すると弱く,H. pyloriのco-promoterとして働いていると考えられた.スナネズミ腺胃で,食塩はH. pyloriが好む胃腺窩上皮由来ムチンを増加させ,抗H. pylori作用を有する胃腺由来のムチンを減少させた.H. pylori陽性スナネズミ腺胃癌には胃型,胃腸混合型,腸型,ヌル型のすべてのタイプが発生したのに対して,H. pylori陰性胃癌では,病理組織型に関係なく,すべて胃型であった.胃癌予防の観点から,H. pylori感染者の食塩制限は重要であると考えられた.
Theme Candidate Causes of H. pylori-Negative Gastric Cancer
Title Life Style and Stomach Cancer : Salt and Stomach Cancer
Author Tsutomu Mizoshita Division of Oncological Pathology, Aichi Cancer Center Research Institute
Author Tetsuya Tsukamoto Division of Oncological Pathology, Aichi Cancer Center Research Institute
Author Masae Tatematsu Division of Oncological Pathology, Aichi Cancer Center Research Institute
[ Summary ] Salt promotes gastric carcinogenesis in Helicobacter pylori (Hp) infected glandular stomach of Mongolian gerbils (MGs) treated with N-methyl-N-nitrosourea (MNU) in a dose-dependent fashion. Hp infection alone is a much stronger factor than high-salt diet administration in regard to gastric carcinogenesis, salt itself being rather a co-promoter of gastric adenocarcinoma development, especially in combination with Hp. In the present study, salt was found to induce an increase in the surface area of mucous cell type mucins (SMCM) in which Hp is localized, and a decrease in gland mucous cell type mucins (GMCM), which defend against Hp infection. The bacteria induced an increase in MUC 6 mRNA levels, while salt had no influence on MUC 5 AC or MUC 6 mRNA expression in the MG model. Thus, salt alters the mucous microenvironment by increasing the SMCM : GMCM ratio to help Hp colonize and exacerbate inflammation. All glandular stomach carcinomas were classified as gastric phenotype (G type) in non-infected MGs, independent of the histological type, whereas Hp-infected animals harbored all types of cancers including G, gastric-and-intestinal mixed (GI), intestinal (I), and null (N) types. Restriction of salt intake appears to be important for the prevention of stomach cancers in patients with Hp infection.
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