每周二、四为您推送近期幽门螺杆菌相关文献摘要，追踪学术进展。

Helicobacterpyloriinfection,chronicatrophicgastritisandriskofstomachandesophaguscancer:Resultsfromtheprospectivepopulation-basedESTHERcohortstudy

幽门螺杆菌感染、慢性萎缩性胃炎与胃癌和食道癌风险：基于人口的前瞻性ESTHER队列研究结果

Abstract摘要

Background:

Helicobacterpylori(H.pylori)infectionisconsideredasprincipalcauseofgastriccancer.Itisfurtherassociatedwithareducedriskofesophagealadenocarcinomas.

背景：

幽门螺杆菌（H.pylori）感染被认为是引起胃癌的主要原因。同时，它还与食道腺癌的风险降低有关。

Method:

DatafromtheESTHER(Epidemiologicalinvestigationsonchancesofpreventing,recognizingearlyandoptimallytreatingchronicdiseasesinanearlypopulation)cohortstudyfromGermanywereused.Inalargeprospectivepopulation-basedcohortstudyincluding9,subjectswithaverageobservationtimeof13.8years,weassessedtheriskofinvasivegastricandesophagealcanceraccordingtoH.pyloriinfectionandpresenceofchronicatrophicgastritis(CAG).Incidenceratesandhazardratios(HR)derivedbyCoxproportionalhazardsmodelsandadjustedforrelevantconfounderswerederivedbyseroprevalenceofH.pyloriandcytotoxin-associatedgeneA(CagA)antibodiesandpresenceofCAGbasedonserologicalmarkersatbaseline,respectively.

方法：

使用数据来源于德国ESTHER（关于人群中早期预防、识别和优化治疗慢性疾病机会的流行病学调查）队列研究。在一项包括9,名受试者、平均观察时间为13.8年的大型前瞻性人群队列研究中，我们根据幽门螺杆菌感染情况和是否有慢性萎缩性胃炎（CAG）评估了浸润性胃癌和食道癌的风险。根据基线时的血清学标记，幽门螺杆菌和细胞毒素相关基因A（CagA）抗体的血清阳性率以及是否诊断为CAG，通过Cox比例危害模型来计算得出发病率和危险比（HR），并调整相关混杂因素。

Results:

Duringfollow-up,30casesofnoncardiagastriccancerand33casesofesophagealcancerwereobserved.InfectionbyH.pyloriwithoutandwithexpressionofCagAwasassociatedwitha5.2-fold(95%confidenceinterval1.00–27.1)andan18.2-fold(4.3–77.4)increaseofnoncardiagastriccancerincidence.A0.65-folddecreasedriskofesophagealadenocarcinomas(HR0.35,0.12–0.97)wasobservedamongH.pylori-infectedindividuals.InparticipantsinfectedwithCagAexpressedH.pylori,thepresenceofmild/moderateandsevereCAGwasassociatedwitha6.4-fold(1.3–31.0)andan11.8-fold(3.1–45.4)increaseofgastriccancerincidence,respectively.

结果：

在随访期间，共观察到30例非贲门胃癌和33例食管癌。无CagA表达的Hp感染和有CagA表达的Hp感染，非贲门胃癌的发病率分别增加5.2倍（95%CI1.00-27.1）和18.2倍（95%CI4.3-77.4）。在幽门螺杆菌感染者中观察到食道腺癌的风险降低了0.65倍（HR0.35,0.12-0.97）。在感染了CagA表达的幽门螺杆菌的参与者中，轻度/中度和重度CAG的存在分别使胃癌发病率增加6.4倍（1.3-31.0）和11.8倍（3.1-45.4）。

Conclusion:

Theresultsofthisprospectivepopulation-basedcohortstudymaycontributerelevantevidencetotheongoingresearchofH.pylori-relatedcancers.TheresultsmayfurthermoreenhancetheempiricalbasisforriskstratificationamongH.pylori-infectedpeopleandforre