| Theme |
Precancerous Conditions and Cancer High-risk Lesions in the Esophagus and the Stomach |
| Title |
Gastric Cancer Due to Helicobacter pylori-Associated Gastritis : Finding from Ten Year Follow-up Study |
| Author |
Kimihiko Yanaoka |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Chizu Mukoubayashi |
Wakayama Wellness Foundation |
| Author |
Mikitaka Iguchi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Masashi Oka |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Osamu Mohara |
Wakayama Wellness Foundation |
| Author |
Masao Ichinose |
Second Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
5,209 asymptomatic, middle-aged male subjects, whose serum pepsinogen (PG) and anti-H. pylori antibody levels had been assessed, were followed for 10 years. Subjects with positive serum anti-H. pylori antibodies (> 50 U/ml) had an increased cancer risk (HR=3.48, 95% CI=1.26-9.64). Cancer development increased as serum antibody levels increased; the H. pylori-positive group with antibody levels > 500 U/ml had the highest incidence rate (325/100,000 person-years). Cancer development also increased with reduced serum PG I levels or reduced PG I/II ratios; the risk was significantly elevated with serum PG I levels of ≤30 μg/l (HR=3.54, 95% CI=1.95-6.40) or PG I/II ratios of ≤3.0 (HR=4.25, 95% CI=2.47-7.32). Furthermore, the risk of diffuse-type cancer increased as PG II levels increased. Risk was significantly elevated with PG II levels of ≥30 μg/l (HR=3.81, 95% CI=1.10-13.21). Using anti-H. pylori antibody levels and PG levels, subgroups with especially high or low cancer incidence rates were identified. H. pylori-negative or indeterminate subjects with low PG levels of (PG I ≤30 μg/l or PG I/II ratio ≤2.0) or H. pylori-positive subjects with antibody levels >500 U/ml, as well as those with low PG levels who were among the subgroups with high cancer incidence rates (over 400/100,000 person-years). In contrast, H. pylori-negative subjects with a PG I level >70 μg/l or a PG I/II ratio>3.0 had the lowest risk; none of these developed cancer. Thus, serum PG levels and/or anti-H. pylori antibody levels can be used to formulate a long-term prognosis of cancer development in individuals with H. pylori-related gastritis. |