Eight-year follow-up study on prevalence of gastric cancer and the histopathological changes of gastric mucosa after H.pylori eradication
- VernacularTitle:根除幽门螺杆菌对胃癌患病率及胃黏膜组织学变化的八年随访研究
- Author:
Liya ZHOU
;
Sanren LIN
;
Shigang DING
- Publication Type:Journal Article
- Keywords:
Helicobacter pylori;
Gastric cancer;
Gastric body;
Atrophy;
Intestinal metaplasia
- From:
Chinese Journal of Digestion
1998;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prevalence of gastric cancer and the relationship between H.pylori infection and the histopathologic changes of gastric mucosa in patients who had their H.pylori eradicated for 8 years in the high incidence region of gastric cancer. Methods One thousand and six adults(age from 35 to 75 years old)were randomly selected in Yantai area, Shandong province in 1996. Five hundreds and fifty two individuals with H.pylori positive were randomly divided into treatment group (n=276) and placebo group(n=276). Treatment group received triple therapy (omeprazol, amoxycillin and clarithromycin) for one week. The placebo group was served as control. One month after completion of treatment, H.pylori status was reassessed by 13C-UBT. Eradication rate of H.pylori in the treatment group was 89%.Follow-up study was carried out with endoscopy in the 2nd, 5th and 8th year, respectively. The endoscopic appearance and histology of the biopsies from the same site obtained at the first and final endoscopy were compared. Results ①At the 8th year′s follow up, 7 patients deve-loped gastric cancer, 1 in the H.pylori negative group(n=246)and 6 in the H.pylori positive group(n=306). The prevalence was 1/1968 person years in the treatment group and 6/2448 person years in placebo group(P0.05). ③ Eight years after eradication of H.pylori , the proportion of gastric atrophy in the body in the H.pylori eradication group was much lower than that in the non-eradication group(P0.05). Conclusions H.pylori infection increased the risk of gastric cancer occurrence, H.pylori eradication is able to reduce such risk. H.pylori eradication results in reduction in the pre-valence of gastric atrophy in the body, while continued H.pylori infection leads to progressive aggrava-tion of gastric atrophy and intestinal metaplasia.
