RELATION OF GASTRIC CANCER WITH HELICOBACTER PYLORI INFECTION AND DIETARY HABITS

• Published in: Journal of The Showa Medical Association Vol. 58; no. 6; pp. 479 - 486
• Main Authors: SEKIKAWA Takashi, MASAKI Motofumi, NAKAMURA Ken-ichi
• Format: Journal Article
• Language: English
• Published: 昭和大学学士会 1998; The Showa University Society
• Subjects: dietary habits; gastric cancer; Helicobacter pylori; pepsinogen; ペプシノゲン; 胃癌; 食生活習慣
• ISSN: 0037-4342; 2185-0976
• DOI: 10.14930/jsma1939.58.479

Recently, the relationship between gastric cancer and Helicobacter pylori infection is attracting much attention. We analyzed the effects of Helicobacter pylori infection and dietary habits on the occurrence of gastric cancer using a nested case-control study method. We carried out a questionnaire survey on the life styles of 5768 males over 40 years old at a health insurance society in Tokyo in 1988. We collected serum specimens from 849 examinees obtaining their consent for future study and storaged at -80°C. Thereafter we have been tracing the occurrence of cancer. Subjects were 15 newly-registered gastric cancer cases and 30 controls matched for age. For these 45 subjects, serum Helicobacter pylori antibody (HP antibody), pepsinogen (PG) I, PGII and PGI/II were examined.The results were as follows:(1) The HP antibody positivity rate of all subjects was 64.4%, 80.0% in the gastric cancer cases and 56.7 % in the controls (odds ratio, 3.06; 95 % confidence interval, 0.72-13.0) .(2) The PG I/II ratio was 2.13 in the cancer cases and 3.75 in the controls (P<0.05) .(3) The dietary habits survey revealed that the cancer cases drank coffee more frequently than the controls.(4) The multivariate analysis indicated that the low level of PGI/II exerted the strongest influence on occurrence of gastric cancer.These results suggest that Helicobacter pylori infection contributes to the occurrence of gastric cancer to some degree, but a low level of PGI/II is a higher risk factor. Some of the subjects' dietary habits are also suspected as risk factors and further investigation is needed. 目的; 最近胃癌とHelicobatter pylori (H.pylori) 感染との関連が注目されている.今回我々はH.pylori感染及び食生活習慣の胃癌発生との関連を疫学的に検討するためにnestedcase-control studyの手法を用いて研究を行った.研究方法; 東京都内の某健保組合に所属している40歳以上の男性5768名について, 1988年7～9月に生活習慣調査を実施し, その内849名については血清を採取して凍結保存し, 以後悪性新生物発生状況を追跡している.その中から胃癌が発生したもの15名と, 胃癌を含む悪性新生物の発生が確認されておらず, 胃癌発生例と同年齢の者2名づつの30名, 合計45名を観察対象とした.これらについてH.pylori抗体 (HP抗体) , ペプシノゲン (PG) I, PGII, PGI/IIを測定し, 分析検討した.結果; 1.全体のHP抗体陽性率は64.4%であった.胃癌症例群では陽性率は80.0%, 対照群では56.7%であった (オッズ比3.06; 95%信頼区間0.72-13.0) .2.PGI/IIは胃癌症例群では2.13, 対照群では3.75であり, 有意差が認められた (P<0.05) .3.食生活習慣では胃癌症例群は対照群に比較して, コーヒーを飲む回数が有意に多かった.4.多変量解析の結果, PGI/IIが胃癌発生に対して最も強い影響を与えていた (オッズ比11.2; 95%信頼区間2.13-59.3) .結論; 胃癌発生にH.pylori感染単独でも影響を与えるが, PGI/II低下の影響が大きく, また食生活習慣でも, 胃癌発生に影響があることが示唆された.