Helicobacter pylori infection and gastric cancer. A nested case-control study in a rural area of Japan.
We conducted a seroepidemiological nested case-control study to determine the association of gastric cancer with Helicobacter pylori infection and atrophic gastritis. A cohort of 2858 participants in an annual multiphasic health check-up were followed for eight years. Data for 45 gastric cancer cases and 225 sex-, age-, and address-matched control subjects were analyzed. Helicobacter pylori infection was determined by IgG antibodies, and atrophic gastritis was diagnosed by both serum pepsinogen I level (< or = 70 ng/ml) and the pepsinogen I/II ratio (< or = 3.0). Univariate analysis showed that Helicobacter pylori and atrophic gastritis were significantly associated with gastric cancer. In a multivariate analysis, atrophic gastritis was associated with significantly increased risk of cancer (odds ratio, 3.38; 95% confidence interval, 1.54-7.42); however, Helicobacter pylori was not associated with cancer (odds ratio, 1.84; 95% confidence interval, 0.59-5.72). These results suggest that Helicobacter pylori infection alone is not directly associated with gastric carcinogenesis but has an indirect relation to gastric cancer through the development of atrophic gastritis.
Watanabe
Y
Y
Department of Preventive Medicine, Kyoto Prefectural University of Medicine, Japan.
Kurata
J H
JH
Mizuno
S
S
Mukai
M
M
Inokuchi
H
H
Miki
K
K
Ozasa
K
K
Kawai
K
K
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010435:Pepsinogens / Q000097:blood; D012042:Registries; D012307:Risk Factors; D012424:Rural Population; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000382:microbiology*
D010435:Pepsinogens