A Case-Control Study of Stomach Cancer and Its Genesis in Relation to Alcohol Consumption, Smoking, and Familial Cancer History

A case-control study of stomach cancer and its genesis has been conducted in relation to alcohol consumption, cigarette smoking, and familial cancer history. Two hundred and ninety-four cancer cases, discovered by mass screening and histologically verified after endoscopic examination, have been compared with 588 randomly selected controls, who received the same early detection program and were verified as being free of the disease. No statistically significant association was observed between the development of stomach cancer and alcohol consumption or familial cancer history. However, the development of stomach cancer was found to have a positive correlation with smoking (relative risk for those who smoke less than 19 cigarettes/day, 3.56: 95% confidence interval, 2.39 to 5.31; relative risk for those who smoke more than 20 cigarettes/day, 2.58: 95% confidence interval, 1.60 to 4.17). The results of this study suggest that cigarette smoking appears to have a more harmful effect on the development of stomach cancer than either alcohol consumption or a familial history of cancer. The high relative risk of smoking revealed by this study implies that further research on the effects of smoking in the development of stomach cancer would be desirable.     

Second Primary Cancer after Diagnosis of Stomach Cancer in Osaka, Japan

The risk of developing a second primary cancer following stomach cancer was estimated from data accumulated in the Osaka Cancer Registry. Of the 38,777 male patients and 22,391 female patients newly diagnosed in the period 1966–1986 who were followed up until the end of 1986, 778 and 267 developed a second cancer other than stomach cancer, respectively, whereas the expected numbers had been 928.8 (RR=0.84, 95%CI=0.78-0.90) and 297.7 (RR = 0.90, 95%CI = 0.79-1.01). The risks were higher among younger patients (aged 30–54 at the diagnosis of stomach cancer) than among older patients (aged 55–69 at the diagnosis of stomach cancer). Significantly elevated risks were observed for cancers of the oral cavity & pharynx (RR=l.56), colon (RH = 1.61) and rectum (RR = 1.56) for males, and oral cavity & pharynx (RR = 2.59) for females as second cancers. Results were substantially similar among the localized stomach cancer patients. Among younger male patients with gastrectomy, the risk of developing pancreatic cancer was elevated 10 or more years after stomach cancer diagnosis. The present study suggests the necessity of following up stomach cancer patients in order to enable the early diagnosis of digestive tract cancer.     

Tobacco Smoking and Alcohol Drinking as Risk Factors for Stomach Cancer: a Case-Control Study in Uruguay

Objectives: To estimate the risk of stomach cancer associated with alcohol drinking and tobacco smoking in Uruguayan men.Methods: A case-control including 331 cases and 622 controls was conducted in Montevideo, Uruguay, during the period 1992-96. The study was restricted to men, and both cases and controls were patients admitted to the major four hospitals in Montevideo. Response rates were high and similar for both series (92.8 for cases and 92.6 percent for controls). Controls were frequency-matched to cases on age and residence, and patients with conditions related a priori to tobacco smoking and alcohol drinking were considered ineligible for the study. All patients were interviewed shortly after admission using a structured questionnaire by two trained social workers. Relative risks, approximated by the odds ratios (OR), were estimated by unconditional logistic regression in models including major potential confounders.Results: Smoking duration was associated with an increased risk of 2.2 for smokers of more than 50 years, with a significant dose-response pattern, after controlling for major confounders. Quitters of more than 15 years displayed an OR of 1.1, very close to the risk of never-smokers. A younger age at having started smoking was associated with an increased risk, whereas pack-years of cigarettes showed a significant dose-response. Also, alcohol drinking (particularly hard liquor and beer) was associated with an OR of 2.4 (95 percent confidence interval = 1.5-3.9), after controlling for the effect of tobacco, vegetables, and other types of alcohol beverages.Conclusions: These findings add further support to the role of tobacco and alcohol in gastric carcinogenesis. Cancer Causes and Control 1998, 9, 321-329     

Atrophic Gastritis and Stomach Cancer Risk: Cross-sectional Analyses

The relationship between atrophic gastritis and stomach cancer risk was investigated in case-control analyses involving 387 cases with stomach cancer and 5,422 control subjects who received gastroscopic examination at Aichi Cancer Center Hospital from April, 1985 to March, 1989. The presence of atrophic gastritis, the degree and extension of the atrophy and the presence of granularity and erosion were diagnosed endoscopically by six gastroenterologists. The prevalence of atrophic gastritis increased with age and was higher in males than in females. The relative risk (RR) of stomach cancer was S.13 (95% confidence interval (CI): 2.79–9.42) if a subject had any type of atrophic gastritis. The risk further increased with advancing degree of atrophy and increasing extension on the greater and lesser curvatures. The RR associated with severe atrophy was 7.73 (95% CI: 3.95–15.12). These associations remained significant when analyzed by sex and age. The presence of granularity and erosion did not much affect the estimated risks. A clear difference in risk appeared in the analyses by histological type of cancer. The RR associated with atrophic gastritis was 24.71 (95% CI: 3.46–176.68) for the intestinal type and 3.49 (95% CI: 1.77–6.87) for the diffuse type. These findings may suggest a need for intensive follow-up of patients with severe atrophic gastritis.     

吸烟和环境烟草烟雾暴露与女性肺癌的关系的病例──对照研究

在上海市区进行了女性肺癌病例—对照研究中共调查新病例649例，对照675例。资料分析表明各种组织学类型肺癌都与吸烟有联系．其中鳞癌和小细胞癌与吸烟关系非常密切．OR分别为5.6和9．9，吸烟使腺癌危险性略有增加，OR=1.195％可信阳=0.7～1.7,吸烟对肺癌总的相对危险度为2.4（95％可信限=1.8～3.3）。各类肺癌的危险性均随每日吸烟量的增加、吸烟年限的延长和开始吸烟年龄的提前而增加。鳞癌和小细胞癌危险性上升速度最快，腺癌危险性增加缓慢，且趋势不显著。本研究还发现工作环境中的环境烟草烟雾暴露使女性非吸烟者肺癌危险性增加到1.5倍，95％可信限=1．1～2.0。未发现儿童期父母吸烟和成年期丈夫吸烟增加女性非吸烟者肺癌危险性。     

Smoking Habits and Carcinoma of the Stomach: A Case-Control Study

Over a period of 8 years, a case-control study was carried out on smoking habits in 117 patients with carcinoma of the stomach and 234 controls, and a significant association of a particular method of smoking with the site of gastric carcinoma was found in the cancer patients. Furthermore, there was a highly significant difference in method of smoking between the cancer patients and the control group. The prevalence of smoking habit in the latter was 37%, of which 26% had swallowed the smoke regularly. In contrast, the incidence of smoking habit in the cancer patients was over 56%, of which 64% had swallowed the tobacco smoke. The difference is highly significant (P < 0.001). The study also suggests that the distal part, in particular, the antrum of the stomach was affected more frequently among the smokers of the cancer patients who had swallowed the smoke regularly but the cardiac end seemed to be involved more often in the other groups of the cancer patients. These included'never-smokers,'ex-smokers and those smokers who did not swallow the smoke (P < 0.01). It is therefore concluded that the swallowing of tobacco smoke seems to influence the site of gastric carcinoma. The relative risk was six-fold higher among the smokers who did swallow the smoke compared with the 'never-smokers' of the control group.     

A Prospective Study of Atrophic Gastritis and Stomach Cancer Risk

The relation of atrophic gastritis, other gastric lesions and lifestyle factors to stomach cancer risk was prospectively studied among 3,914 subjects who underwent gastroscopic examination and responded to a questionnaire survey at the Aichi Cancer Center Hospital. During 4.4 years of follow-up on average, 45 incident cases of stomach cancer were identified at least three months after the initial examination. If the baseline endoscopic findings indicated the presence of atrophic gastritis, the risk of developing stomach cancer was increased 5.73-fold, compared with no indication at the baseline. The risk further increased with advancing degree of atrophy and increasing extension of atrophy on the lesser curvature. These trends in the relative risks were statistically significant ( P = 0.027 and P = 0.041, respectively). The risk of developing stomach cancer was statistically significantly increased among subjects with gastric polyps, but not among those with gastric ulcer. Stomach cancer cases tended to consume more cigarettes, alcohol, rice, pickles and salted fish gut/cod roe and less fruits and vegetables and to have more family histories of stomach cancer than noncases, although these differences were not statistically significant. The results of the present study provide additional evidence on the relation between atrophic gastritis and stomach cancer and suggest a need for intensive follow-up of patients with atrophic gastritis and gastric polyps.     

Dietary Protective and Risk Factors for Esophageal and Stomach Cancers in a Low-epidemic Area for Stomach Cancer in Jiangsu Province, China: Comparison with Those in a High-epidemic Area

Comparative epidemiological studies with ecological and case-control approaches in high- and low-epidemic areas of China have provided us with much evidence with regard to risk and benefit in the environment. To clarify how dietary factors are involved in esophageal and stomach cancer development, we performed a case-control study in a low-epidemic area, and compared the findings with those obtained earlier for a high-epidemic area for stomach cancer in the same Jiangsu Province, China. We recruited 199 and 187 cases with esophageal and stomach cancers, respectively, and 333 population-based common controls. Odds ratios (ORs) for esophageal and stomach cancers were calculated with adjustment for potential confounding factors, using an unconditional logistic model. Current and former smoking elevated the OR for esophageal cancer, along with high intake of pickled vegetables and broiled meat, while decreased ORs were observed for frequently consumed raw vegetables and garlic. With regard to stomach cancer, ORs were increased with frequent consumption of salty fish, leftover gruel, and broiled meat, and lowered by snap bean consumption. The present risk factors were common to the previously obtained results in the high-epidemic area, and similarly distributed in each general population. While more protective factors were observed in the high-epidemic area, their penetrance was much greater in the low-epidemic area. The present study thus suggests that frequent vegetable and garlic consumption contributes to low mortality rates for esophageal and stomach cancers in a low-epidemic area, counteracting similar exposure levels for risk factors as in the high-epidemic area
.     

Tobacco Smoking and Risk of Second Primary Lung Cancer

IntroductionLung cancer survivors are at high risk of developing a second primary lung cancer (SPLC). However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. We examined the risk factors for SPLC across multiple epidemiologic cohorts and evaluated the impact of smoking cessation on reducing SPLC risk.MethodsWe analyzed data from 7059 participants in the Multiethnic Cohort (MEC) diagnosed with an initial primary lung cancer (IPLC) between 1993 and 2017. Cause-specific proportional hazards models estimated SPLC risk. We conducted validation studies using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (N = 3423 IPLC cases) and European Prospective Investigation into Cancer and Nutrition (N = 4731 IPLC cases) cohorts and pooled the SPLC risk estimates using random effects meta-analysis.ResultsOverall, 163 MEC cases (2.3%) developed SPLC. Smoking pack-years (hazard ratio [HR] = 1.18 per 10 pack-years, p < 0.001) and smoking intensity (HR = 1.30 per 10 cigarettes per day, p < 0.001) were significantly associated with increased SPLC risk. Individuals who met the 2013 U.S. Preventive Services Task Force’s screening criteria at IPLC diagnosis also had an increased SPLC risk (HR = 1.92; p < 0.001). Validation studies with the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and European Prospective Investigation into Cancer and Nutrition revealed consistent results. Meta-analysis yielded pooled HRs of 1.16 per 10 pack-years (p_meta < 0.001), 1.25 per 10 cigarettes per day (p_meta < 0.001), and 1.99 (p_meta < 0.001) for meeting the U.S. Preventive Services Task Force’s criteria. In MEC, smoking cessation after IPLC diagnosis was associated with an 83% reduction in SPLC risk (HR = 0.17; p < 0.001).ConclusionsTobacco smoking is a risk factor for SPLC. Smoking cessation may reduce the risk of SPLC. Additional strategies for SPLC surveillance and screening are warranted.     

Calcium and Magnesium in Drinking Water and Risk of Death from Colon Cancer

The possible association between the risk of colon cancer and the levels of calcium and magnesium in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. All eligible colon cancer deaths (1714 cases) of Taiwan residents from 1989 through 1993 were compared with deaths from other causes (1714 controls), and the levels of calcium and magnesium in drinking water of these residents were determined. Data on calcium and magnesium levels in drinking water throughout Taiwan were obtained from the Taiwan Water Supply Corporation. The control group consisted of people who died from other causes and the controls were pair-matched to the cases by sex, year-of-birth, and year-of-death. The adjusted odd ratios (95% confidence interval) were 0.79 (0.64–0.98) for the group with water calcium levels between 24.4 and 42.3 mg/liter and 0.58 (0.47–0.73) for the group with calcium levels of 42.4 mg/liter or more. The adjusted odd ratios were not statistically significant for the relationship between magnesium levels in drinking water and colon cancer. The results of the present study show that there is a significant protective effect of calcium intake from drinking water against colon cancer     

胃溃疡癌的组织学观察

本文复习了1964年至1986年523例普通胃癌资料,为回顾组;并对1987年至1988年77例胃癌标本做系列取材切片,为前瞻组。同时以100例胃良性溃疡病进行对照。根据Hauser氏胃溃疡癌诊断标准,对慢性胃溃疡、胃溃疡伴胃癌、溃疡癌、癌溃疡和溃疡癌伴胃癌进行组织学观察,探讨了这些病变之间的关系。提出溃疡底疤痕组织呈“山峰状”改变,粘膜层与肌层靠拢和粘膜下层受挤压是良性胃溃疡与溃疡癌的共同特点。     

胃十二指肠血吸虫病与癌肿发生关系的初探

本文报道30例胃十二指肠血吸虫病合并胃癌,均为手术病理证实。主要从组织学方面进行分析。其中胃窦部28例窦贲门部2例。癌灶处虫卵沉积为33.3％(10/30),十二指肠切缘处为66.7％(20/30)。虫卵均已钙化。癌灶处虫卵周围未见癌变的移行过渡现象,故虫卵诱发癌肿之说,证据不足。十二指肠处虫卵周围无特异性变化,提示十二指肠并未因虫卵沉积而使癌肿发生率增多。推测虫卵只有在其它因素参与下才有可能诱发癌肿。因胃血吸虫病与胃癌的好发部位相同,二者关系有待进一步探讨。十二指肠血吸虫病合并胃癌可认为是偶然并存。     

全胃切除术30年经验总结（附89例报告）

本文通过89例全胃切除的临床资料分析。总结了我院近30年全胃切除的经验体会。对如何掌握手术适应症、胃周淋巴结的清除以及消化道的重建方式等提出自己的见解,通过分析对比5种消化道重建的方式,认为“9”字形空肠代胃优点居多。随着外科手术经验的积累和其它有关方面的进展,全胃切除由过去较为保守态度转为积极态度,5年治愈率逐渐提高,而手术死亡率及合并症、术后远期后遗症相应下降。     

Waterpipe Tobacco Smoking and Risk of Stomach Cancer: A Case-Control Study in Vietnamese Men

Objective: This study investigated the impacts of waterpipe tobacco (WTP) and cigarette smoking on stomach cancer development in Vietnamese men. Methods: A total of 80 stomach cancer cases and 146 controls were recruited in a hospital-based case-control study. Data on sociodemographic, anthropometric characteristics, tobacco smoking, and the dietary pattern was obtained based on a semi-quantitative food frequency and demographic lifestyle questionnaire; and venous anti-Helicobacter pylori IgG antibodies were tested by ELISA. Unconditional logistic regression analysis with adjustments for potential confounding was performed to estimate the association between target exposures and stomach cancer. Results: Compared to the never tobacco smokers, the risk of stomach cancer significantly increased among tobacco smokers (OR 2.95, 95%CI 1.26-6.90, p=0.013). Those who early started tobacco smoking before 26 years old had a high risk of SC (OR 3.04, 95%CI 1.29-7.20, p for trend=0.011). For types of tobacco, It was increased risk in exclusively cigarette smokers (OR 2.85, 95%CI 1.19-6.85, p=0.019) and in WPT smokers (OR 3.09, 95%CI 1.24-7.68, p=0.015). The daily frequency and longer duration of exclusively WPT or cigarette smoking tended to be significantly higher SC risk. Conclusions: The findings suggest that tobacco smoking, particularly water pipe tobacco smoking, dramatically and independently increased the risk of stomach cancer.     

A Prospective Study of Stomach Cancer among a Rural Japanese Population: A 6-Year Survey

Stomach cancer mortality was prospectively studied among 9753 Japanese men and women who first responded to a mailed questionnaire in 1985 and were then followed through May 31, 1991. During this follow-up period, 57 stomach cancer deaths were identified. Current smokers had an increased risk of deaths from stomach cancer compared with never smokers (relative risk (RR) = 2.29, 95% confidence interval (CI): 1.15–4.56), but there was no dose-response to amount of cigarettes smoked. Daily alcohol drinkers who consumed 50 ml or more of alcohol per day also had a greater risk than nondrinkers (RR = 3.05, 95% CI: 1.35–6.91). There was no association between stomach cancer mortality and individual food consumption except a positive association with fruit intake. However, frequent use (≤3–4/week) of broiling of meats and traditional style Japanese salad preparation in their cooking procedures were positively associated with stomach cacer mortality. The RR values compared with infrequent use (≥1–2/month) were 2.27 (95% CI: 1–06–4.85) and 3.10 (95% CI: 1.40–6.85), respectively. A positive family history of cancer, especially stomach cancer, significantly increased the risk of stomach cancer deaths (RR=2.01, 95% CI: 1.12–3.63). The effects of these variables remained after adjustment for other variables.     

河南林州胃癌危险因素的病例对照研究

「目的」探讨胃癌发病的危险因素及保护因素,为综合防治提供流行病学论据。「方法「采用病例－对照研究方法,对３４６例胃癌病人和１５４１例正常人群对照进行固顾性调查。单因素分析出各因素的比值及其９５％可信限,初选因素（Ｐ〈０．１）进行主成份因子分析、应用非条件Ｌｏｇｉｓｔｉｃ回归模型多因素分析。「结果」胃癌的危险因素主要有：上消化道疾病史、十年内有精神创伤、职业物理接触、癌症家族史、高盐饮食及社会经济地     

A Case-Control Study of Single and Multiple Stomach Cancers in Saitama Prefecture, Japan

A case-control study of stomach cancer was done in Saitama Prefecture, Japan, in relation to dietary, smoking, and drinking habits. The study was based on two sets of cases (216 male single and 35 male multiple stomach cancer cases newly diagnosed and of adenocarcinoma type), and 483 male controls derived from residents of Saitama Prefecture. Dietary habits were investigated for the intake of 12 separate foods and 12 food groups by means of a food frequency questionnaire, including individual taste preferences. Among the single stomach cancer series, dose-response relationships were observed for 7 dietary items (preference for salty foods, miso soup, boiled fish, pickled vegetables, nuts, raw vegetables, and seaweed) in the multiple logistic regession analysis. As for the multiple stomach cancer case series, dose-response relationships were observed for 3 dietary items (miso soup, fruits, and seaweed) in the multiple logistic regression analysis. Cigarette smoking and alcohol use were not significantly related to the risk of either single or multiple stomach cancer.     

胃癌多药耐药细胞株的建立及其生物学特征

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抑癌蛋白与胃癌细胞增殖和凋亡的关系

为了探讨抑癌蛋白对胃癌细胞增殖和凋亡的影响，以阐明胃癌恶性生长的可能机理，选择８８例手术切除的胃溃疡和胃癌的蜡块标本，将ＢｒｄｕＴＰ掺入到ＤＮＡ的断端，结合抗Ｂｒｄｕ抗体放大信号，再用免疫组化的方法检测组织中的凋亡细胞。同时采用免疫组化方法检测这些组织中的ｐ２１、ｐ５３及ＰＣＮＡ的表达。结果显示，胃癌组织中的细胞增殖水平高而凋亡细胞减少。癌巢中很少有凋亡细胞。胃溃疡组织中凋亡的细胞明显多于胃癌组织。ｐ５３蛋白在胃癌中的检出率为３８．０％。ｐ２１蛋白在胃粘液腺癌及低分化、未分化型腺癌中检出率很低。结果表明，尽管胃癌组织中发现抑癌基因ｐ５３突变蛋白的表达水平增高，但并不能促使胃癌细胞的增殖，却可以增加癌细胞的凋亡。胃粘液腺癌和低分化、未分化型腺癌的抑癌蛋白ｐ２１的表达水平低下可能是该类癌细胞过度增生的原因之一。胃癌细胞凋亡机制障碍和增殖失控是胃癌细胞增生失控的基础