Analysis of Pathogenic Factors of Helicobacter Pylori in a High Prevalence Area of Gastric Cancer in Xinin,Qinghai Province

OBJECTIVE To analyze positive rates of the specific proteins CagA, VacA, UreA and UreB of Helicobacter pylori (Hp) in people in Xinin city Qinghai Province, a district with a high prevalence of gastric carcinoma, and to examine the relationship among the incidence, gross diagnosis and pathologic diagnosis. METHODS The gastric tissue biopsy specimens taken under endoscopy were examined by CLO,WS and Western Blot to judge the condition of the Hp infection. The positive rates of Hp CagA,VacA,UreA and UreB that had infected patients were evaluated. RESULTS The positive rate of UreA was markedly lower in chronic superficial gastritis (CSG) than in duodenal ulcer (DU) and compound ulcer, and also lower than in chronic atrophic gastritis(CAG), gastric ulcer(GU) and gastric cancinoma. However the positive rate of UreB was notably lower in duodenal ulcer and gastric ulcer than in chronic superficial gastritis and atrophic gastritis. The rates of UreB found in intestinal epithelial metaplasia, atrophic gastritis and gastric carcinoma were notably lower than in other diseases, however, it was markedly increased in chronic superficial gastritis, No differences were found among CagA and VacA of specimens with different endoscopic diagnosis or pathologic diagnosis. CONCLUSIONS The UreA in Hp may be relevant to the pathogenic mechanism of severe gastric diseases. However, UreB may have some protective effect on severe gastric diseases.     

A Case Control Study on Risk Factors for Stomach Cancer in Urban Shanghai

Objective To examine the possible risk factors for stomach cancer among men and women in Shanghai, China. Methods In urban Shanghai, in-person interviews were completed for 311 cases newly diagnosed with stomach cancer of ages 30 -74. Data were collected from April 1999 to October 1999 and compared to 1579 population-based controls (controls in three cancer studies used together). Information on demographic variables, smoking, diet consumption and others was collected from all subjects. Unconditional logistic regression was used to adjust the possible factors. Results Stomach cancer risk in men rose with smoking, eating hot and fried foods, chronic gastritis and a family history of gastric cancer among men; the risk among women was associated with the consumption of preserved, pickled and fried foods, heavy drinking, chronic gastritis, a history of ulcer disease and a family history of gastric cancer. A dose-response relationship was found (trends test,P<0.01) among men smokers. In contrast, the consumption of fresh vegetables and fruits, beans (especially soybeans) and soy products, plant oil, and eggs and egg products, was inversely associated with stomach cancer risk. After adjustment of the potential confounding variables, these associations remained significant. Conclusions The present findings provide further evidence that smoking, eating salted foods (especially salted vegetables), oil-fried foods(including fried cereal, eggs, and peanuts), chronic gastritis, a family history of gastric cancer and so on increase the risk of stomach carcinoma in Shanghai. Fresh vegetables and fruits, beans and soybean products (even after adjusted for use of fresh vegetables and fruits), plant oil, and so on may have protective effects.     

Clinicopathological Analysis as Predictive Factors for Recurrence in Early Gastric Cancer

OBJECTIVE To identify clinicopathological characteristics as predictive factors for recurrence in early gastric cancer(EGC),and to determine which lesions should be removed by gastrectomy by means other than endoscopic mucosal resection(EMR). METHODS Data from 249 patients with EGC were collected and the relationship between their clinicopathological characteristics and postoperative recurrence was retrospectively analyzed by univariate analysis. RESULTS Of the 249 patients a er gastrectomy,19 cases(7.6%) experienced a recurrence.The postoperative recurrence rate was 18.9%(7/37)in patients with lymph node metastasis,and 5.7% (12/212)in those without.Lymph node metastases were found to be significantly related to recurrence in EGC(P=0.005). CONCLUSION Lymph node metastases were the only predictive factor for recurrence in EGC.However,this was not the determining factor for performing gastrectomy rather than EMR.Although after gastrectomy with lymphadenectomy of EGC,patients with lymph node metastasis should be considered as candidates for adjuvant treatment.For lymph-node metastatic EGCs,adjuvant therapy is recommended following gastrectomy with lymphadenectomy.     

Analysis of Metastatic-Related Gene Expression in Gastric Cancer by Low-Density cDNA Microarrays

OBJECTIVE To screen metastatic-related genes in human gastric cancer by a low-density cDNA microarray technique. METHODS A total of 18 paired gastric cancer and adjacent normal mu-cosa were examined by a low-density cDNA microarray containing 23 genes. RT-PCR was used for further verification. RESULTS The mRNA expression of MMP -7, heparanase, S100A4, hTERT, hRad17 in gastric cancers was higher than that in coupled normal mucosa (P=0.002, 0.00011, 0.000072, 0.002, 0.00016 respectively), whereas nm23H1, and CDH1 were lower (P=0.003, 0.012 respectively). The concordance was verified further by RT-PCR with a correlation coefficient of 0.774. In gastric primary lesions the mRNA expression of MMP-7, heparanase and S100A4 was higher in the serosa involved compared to non-involved (P=0.003, 0.009, 0.012 respectively), whereas nm23H1, CDH1, KAI1 were lower (P=0.001, 0.001, 0.006 respectively). With respect to the area of serosa involvement, MMP-7 and heparanase expressions were higher in an area of more than 20 cm2 compared to an area of less than 20 cm2 (P=0.001, 0.02 respectively), whereas nm23H1, CDH1 and KAI1 were lower (P=0.030, 0.041, 0.031 respectively). MMP-7 and hTERT expressions were higher in the heavier lymph node metastatic cases (no less than 7) than in the lighter lymph node metastatic cases (no more than 6, P=0.001, 0.005 respectively). CONCLUSION Expression of MMP -7, S100A4, heparanase, hTERT, KAI1, CDH1 and nm23H1 correlated closely with invasion and metastasis in gastric carcinomas. The low-density cDNA microarrays can be used to examine the expression of many genes simultaneously, parallely and quickly.     

Colon Cancer Risk Factors in Jiashan County of Zhe-jiang Province, the Highest Incidence Area in China

OBJECTIVE To investigate the risk factors of colon cancer in Jiashan county, the highest incidence area in China and to provide a scientific basis for monitoring and prevention. METHODS With a population-based case-control study, 109 colon cancer patients with 1:7 matched controls were interviewed with uniform questionnaires. Conditional logistic regression was used for univariate and multivariate analysis of colon cancer. RESULTS High monthly pork consumption (OR=1.608), and high monthly animal fat consumption (OR=1.391) over a ten-year period, psychological depression (OR=9.887), negative emotion (OR=1.723), lower digestivetract diseases (OR=4.163), and history of colorectal cancer in first-degree relatives (OR=3.421) were the main risk factors of colon cancer. During that time, high monthly vegetable consumption was a protective factor for colon cancer (OR=0.422).CONCLUSIONS Colon cancer in Jiashan county was related to dietary factors. The research results support the colon cancer etiological hypothesis of “fat-bile acid“ and “deficiency of dietary fibre“. Psychological depression, in heritance and lower digestive tract diseases were also correlated with colon cancer.     

Treatment of Unresectable Advanced Gastric Cancer Using Iodine-125 Brachytherapy

OBJECTIVE The purpose of the study was to examine the efficacy of treating patients with advanced gastric cancer using iodine-125 （^125Ⅰ） brachytherapy. METHODS Ten patients with unresectable advanced gastric cancer were selected based on their pattern of CT scans. We utilized a brachytherapy planning system to determine the distribution of the ^125Ⅰ seeds, their activity and quantity. The matched peripheral dose （MPD） was 110-135 Gy.^125Ⅰ seeds were implanted in a single plane or biplane by an intraoperative small incision or percutaneous puncture. The postoperative hemogram, CT, KPS, pain-relieving period and survival period were recorded. RESULTS One patient developed a complete response （CR）, 4 patients a partial response （PR）, 3 patients showed no change （NC） and 2 patients developed progressive disease （PD）. The overall response rate （CR＋PR） was 50% （5/10）. The pain-relieving rate was 89% （8/9）. The patients＇ appetite and KPS were improved. The longest survival period was 10 months and median life span was 4 months. There were 8 patients whose seeds fell off resulting in an expulsion rate of 3.8% （26/692）. The patients showed 0-1 degree acute radio-therapeutic side-effects without other symptoms such as abdominal pain, vomitus cruentes or intestinal obstruction etc. CONCLUSION Applying ^125Ⅰ implantation to treat advanced gastric cancer with a reasonable seed distribution can significantly improve clinical symptoms and their quality of life. The radioactive damage is mild. This method can be used as an important supplementary treatment for unresectable advanced gastric cancer.     

Expression of Pepsinogen C in Gastric Cancer and Precancerous Diseases and its Clinical Significance

Objective To investigate the active expression of pepsinogen C (PGC) and its value in detection of precancerous diseases and gastric cancer. Methods Immunohistochemistry was used to examine the expression of pepsinogen C in 424 specimens of gastric mucosa collected by gastroscopy. Results The positive rate of PGC expression in 54 cases of normal gastric mucosa was 100 % and 2.4% in 124 cases of gastric cancer. The positive rate of PGC expression in superficial gastritis, gastric ulcer or erosion, atrophic gastritis or gastric dysplasia and gastric cancer decreased significantly in the sequence indicated (P< 0.05). Conclusion The expression of PGC is negatively correlated with the degree of malignancy of gastric mucosa and with development of gastric lesions. PGC expression has a high sensitivity and specificity for diagnosis of precancerous diseases which can lead to gastric cancer and may be a good indicator for screening and diagnosis of gastric cancer and precursors of gastric cancer. This work was supported by the National Key Technologies R&D Program [No. 2001BA703B06 (B)], and the Natural Science Foundation of China (No. 30171054).     

Assessment of Risk Factors in Laryngeal Cancer in India : A Case- Control Study

Cancer of the larynx is fourteenth most common cancer in the world. Limited data are available from India on ‍associations with risk factors and hence the present hospital based matched case-control study was conducted. ‍Three hundred and five laryngeal cancer patients and an equal number of healthy controls matched for their age ‍within 2 years, sex and place of residence constituted the study population. A pre-tested, semi-structured questionnaire ‍was administered to each individual to elicit information on their socio-demographic profile, food habits and risk ‍factors and dietary consumption patterns. Univariate logistic regression analysis and multivariate forward stepwise ‍conditional logistic analysis were performed. In the univarite analysis a lower consumption of roots and tubers ‍green leaf vegetable other vegetables and fruits, and higher consumption of milk, eggs, meat, tea, alcohol , smoking, ‍consumption of betel leaf with tobacco as well as a preference for spicy and fried foods emerged as significant ‍positive variables. After adjusting for education, years of use of alcohol, smoking, chewing of betel leaf with tobacco ‍in the model, low green leafy vegetables and preference for spicy foods were found to be positively related to the risk ‍of laryngeal cancer. There was a significant difference in the dietary consumption patterns of laryngeal cancer ‍patients and controls, indicating a role for nutritional factors in the etiology of laryngeal cancer in the Indian ‍population. ‍     

胃癌高发区武威市胃癌发病因素探讨

背景与目的:国内外研究结果显示,胃癌的流行因素涉及居民的生活习惯、进食霉变食品和腌制酸菜、营养失衡、微量元素缺乏以及遗传等因素。本研究旨在探讨这些因素在我国西北部胃癌高发区-武威市的普遍性,给胃癌一级预防提供病因线索。方法:用病例-对照研究方法对武威市居民的胃癌家族史进行调查。按Li-M antel-Cart法及Falconer回归法计算胃癌分离比与遗传度。用家访及胃镜+胃粘膜病理检查对萎缩性胃炎患者进行随访观察。用培养鉴定及实验检测等手段检测居民膳食中的致促癌真菌、挥发性N-亚硝基化合物,胃粘膜中的幽门螺杆菌及293名健康成人血清总维生素C含量。结果:武威市胃癌的分离比为0.077,一级亲属的遗传度为22.91%。萎缩性胃炎人群的人年癌病率为1.09%。居民膳食中检出8种亚硝胺,14种致促癌真菌。健康成人夏季血清总维生素C含量平均为(5.74±2.79)m g/L,其中<5.00m g/L(维生素C不足)者110例(37.54%),≤2.00m g/L(维生素C严重不足)者32例(10.92%)。居民胃粘膜中幽门螺杆菌的检出率高达67%。结论:武威市居民的膳食中存在致促癌真菌、挥发性N-亚硝基化合物等多种强致癌物质,又缺乏维生素C等防护因素是武威市胃癌发病的主要外因,胃内幽门螺杆菌感染、萎缩性胃炎特别是异型增生以及遗传易感性为导致癌变     

百色市胃癌发病危险因素病例对照研究

目的：探讨广西百色市胃癌发病相关危险因素,为当地胃癌的预防提供科学依据。方法：以广西百色市2008—01—012011—12—31新发确诊的667例胃癌作为观察组,以相同的性别、年龄（±5岁）、居住地作为匹配条件,按1：1配比随机抽取当地的健康人群作对照组,自行设计调查问卷获取相关暴露资料,应用条件Logistic回归模型进行单因素和多因素分析。结果：单因素分析发现,文化教育、职业、居住村庄、家庭经济状况、居住地水源匮乏（没有自来水／地下水／江河）、吸烟、饮食不规律、常食用煎炸食品、重盐口味、体力活动状况、发病前心理压抑、胃溃疡及幽门螺杆菌（Heicobactorpylori,Hp）感染等因子与当地胃癌发病相关,P〈0．05。对单因素分析有意义的因子应用逐步向前法多因素分析发现,Hp感染、重盐口味、水资源匮乏、饮食不规律、吸烟和胃溃疡史是胃癌的危险因素。结论：百色市居民胃癌发病与HP感染、胃溃疡史、水源匮乏、吸烟、不良饮食及生活习惯有关。     

武威市胃癌遗传因素研究

目的 :探讨武威市胃癌的遗传因素。方法 :应用移民流行病学研究方法对移居新疆奇台县的武威籍居民的胃癌患病情况进行调查 ;根据胃癌死亡登记资料采用Poisson(泊松 )分布模型拟合 ,并用频数分布拟合优度的 χ2 检验进行验证。胃癌家族史调查采用病例 -对照研究方法 ,对有家族史的胃癌分布用二项分布 (p q) n 模型拟合。胃癌的分离比、遗传度分别采用Li Mantel Cart法与Falconer回归法估算。结果 :移民胃癌一代及后裔均较祖籍武威同期的死亡率 ( 5 7 61/10万 )为低 ,但高于定居地奇台县同期死亡率 ( 2 3 67/10万 )的水平。胃癌在以村为单位和家族中呈现地区和家族聚集性 ,P <0 0 1。胃癌的分离比为 0 0 774,显著<0 2 5。胃癌一级亲属的遗传度为 2 2 91% ,二级亲属遗传度为 2 0 0 7%。结论 :武威市胃癌发病存在遗传易感性 ,遗传所起的作用占 1/4～ 1/5 ,遗传方式为多基因遗传。     

CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study

Helicobacter pylori (H. pylori), atrophic gastritis, dietary and life-style factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis (SCAG) was defined as PGA circulating levels <22 microg/l. Overall, in a conditional logistic regression analysis adjusted for education, smoke, weight and consumption of total vegetables, fruit, red and preserved meat, H. pylori seropositivity was associated with GC risk. Subjects showing only antibodies anti-H. pylori lysate, however, were not at increased risk, while those with antiCagA antibodies had a 3.4-fold increased risk. Overall, the odds ratio associated with SCAG was 3.3 (95% CI 2.2-5.2). According to site, the risk of noncardia GC associated with CagA seropositivity showed a further increase (OR 6.5; 95% CI 3.3-12.6); on the other hand, a ten-fold increased risk of cardia GC was associated with SCAG (OR 11.0; 95% CI 3.0-40.9). These results support the causal relationship between H. pylori CagA+ strains infection, and GC in these European populations even after taking into account dietary habits. This association was limited to distal GC, while serologically defined SCAG was strongly associated with cardia GC, thus suggesting a divergent risk pattern for these 2 sites.     

甘肃省武威市胃癌发病率对比分析

目的:探讨甘肃省武威市胃癌发病特征及其流行趋势。方法:通过建立恶性肿瘤登记报告获取胃癌发病资料。结果:武威市胃癌发病率1991 ~ 1995 年为 61 62/10 万,1996~ 2000 年为 55 .96/10 万,后期低于前期。年龄组发病率前后两期均随年龄的增高而上升,65 岁以前各组前期高于后期,65岁及以后各组后期明显高于前期。结论:武威市胃癌发病呈下降趋势。     

甘肃省武威市肝癌危险因素流行病学研究

 目的　探讨肝癌危险因素在我国西北部肝癌低发区甘肃省武威市的普遍性,给肝癌一级预防提供病因线索。方法　用病例-对照研究方法对武威市居民的肝癌危险因素及家族史进行调查。用简单分离分析方法及Penrose法估计遗传模式,按Falconer回归法计算肝癌遗传度。用培养鉴定及实验检测等手段检测居民膳食中的致（促）癌真菌、挥发性N-亚硝基化合物、饮用水中的硝酸盐、亚硝酸盐、健康成年人血清总维生素C含量。结果　乙肝病史、亲属肿瘤史、食用盐腌食品史、肝硬化病史、饮用地表水与浅井水、饮酒、食用霉变食物等因素是武威市肝癌的危险因素,经分离分析及遗传模式估计,武威市肝癌发病不符合单基因遗传模式,可能为多基因遗传模式。先证者一级亲属的遗传度h2为58.74 %。居民膳食中检出8种亚硝胺,14种致（促）癌真菌。饮用的地表水中硝酸盐氮和亚硝酸盐氮含量分别为（38.97±3.14）mg／L和（0.086±0.043）mg／L;浅井水中硝酸盐氮和亚硝酸盐氮含量分别为（25.88±1.76）mg／L和（0.063±0.032）mg／L。健康成年人夏季血清总维生素C含量为（5.74±2.79）mg／L。结论　乙肝病史、家族肿瘤史、食用盐腌食品史、肝硬化、饮用地表水与浅井水、饮酒、食用霉变食物、饮用水中硝酸盐氮和亚硝酸盐氮含量高、膳食中存在挥发性N-亚硝基化合物等多种强致癌物质、缺乏维生素C等防护因素等是武威市居民肝癌发病的危险因素;遗传易感性为导致癌变的内环境。     

早期胃癌淋巴结转移因素分析

目的探讨影响早期胃癌淋巴结转移的因素。方法对74例术后早期胃癌患者的资料,对各临床病理指标与淋巴结转移的关系进行分析,以确定淋巴结转移的危险因素。结果早期胃癌患者的淋巴结转移率为14.9%（11/74）。单因素分析显示黏膜下癌的淋巴结转移率（27.6%）明显高于黏膜内癌（6.7%）（P=0.020）;未分化型癌的淋巴结转移率（27.6%）明显高于分化型（6.8%）（P=0.042）;肿瘤最大径≤2 cm、〉2-4 cm、〉4 cm 3组间淋巴结转移率有统计学意义（χ2=6.549,P=0.038）。采用Log istic回归进行的多因素分析显示,肿瘤最大径（OR=2.688,P=0.047）和浸润深度（OR=4.508,P=0.044）是影响早期胃癌淋巴结转移的独立危险因素。结论早期胃癌淋巴结转移与肿瘤最大径和浸润深度密切相关,这可为手术方案的选择提供参考。     

Risk of gastric cancer in asymptomatic, middle-aged Japanese subjects based on serum pepsinogen and Helicobacter pylori antibody levels

A total of 5,209 asymptomatic, middle-aged subjects, whose serum pepsinogen (PG) and Helicobacter pylori antibody levels had been assessed, were followed for 10 years. Subjects with positive serum H. pylori antibodies (>50 U/mL) had an increased cancer risk (HR = 3.48, 95% CI = 1.26-9.64). Risk of gastric cancer increased as the antibody level increased; the H. pylori-positive group with antibody levels >500 U/mL had the highest incidence rate (325/100,000 person-years). Cancer development also increased with a reduced serum PG I level or a reduced PG I/II ratio; the risk was significantly elevated with serum PG I level or=30 ng/mL (HR = 3.81, 95% CI = 1.10-13.21). Using H. pylori antibody and PG levels, subgroups with an especially high or low cancer incidence rate could be identified. H. pylori-negative or indeterminate subjects with low PG level (PG I 500 U/mL and a low PG level were among the subgroups with a high cancer incidence rate (over 400/100,000 person-years). In contrast, H. pylori-negative subjects with a PG I level >70 ng/mL or a PG I/II ratio >3.0 had the lowest risk; none of these subjects developed cancer. Thus, serum PG levels and/or H. pylori antibody levels can be used to predict the risk of cancer in individuals with H. pylori-related gastritis from the general population.     

甘肃省武威市胃癌危险因素分析

目的分析甘肃省武威市胃癌高发的危险因素，为胃癌的一级预防提供病因学线索。方法应用移民流行病学研究方法对移居新疆维吾尔自治区奇台县的武威籍居民因胃癌死亡的情况进行调查；地区聚集性分析根据胃癌死亡登记资料采用Poisson分布模型拟合，并用频数分布拟合优度的X^2检验进行验证；家族聚集性分析，采用二项分布（p＋q）^n数学模型拟合，实际发病数与理论数的差异比较用X^2检验；用历史性队列研究方法观察四种癌前疾病的癌变情况；采用紫外分光光度法和盐酸萘乙二胺法分别测定饮用水中的硝酸盐氮和亚硝酸盐氮含量。结果移民胃癌一代及后裔均较祖籍武威市同期的死亡率为低，但高于定居地奇台县同期死亡率水平；胃癌在以村为单位和家族中呈现地区和家族聚集性；胃息肉、萎缩性胃炎、胃溃疡、残胃等四种癌前疾病的人年癌变率依次为0．459％、0．431％、0．381％、0．178％；人群特异危险度百分比依次为41．26％、29．35％、4．68％、3．39％；硝酸盐氮和亚硝酸盐氮无论是地表水还是浅井水武威市均明显高于兰州市（P〈0．01）。结论移民一代及后裔的胃癌死亡率低于祖籍但高于定居地的水平，胃癌发病存在地区与家族聚集性；居民饮用水中富含硝酸盐氮和亚硝酸盐氮；胃息肉、萎缩性胃炎、胃溃疡、残胃等四种胃部慢性疾病为武威市胃癌高发的内在因素。     

Protective effect of green tea on the risks of chronic gastritis and stomach cancer

Despite the declining trend, stomach cancer remains the second most common cancer worldwide. We examined the role of green tea consumption on chronic gastritis and stomach cancer risks. A population-based case-control study was conducted in Yangzhong, China, with 133 stomach cancer cases, 166 chronic gastritis cases, and 433 healthy controls. Epidemiologic data were collected by standard questionnaire and odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models in SAS. Inverse association was observed between green tea drinking and chronic gastritis and stomach cancer risks. After adjusting for age, gender, education, body mass index, pack-years of smoking and alcohol drinking, ORs of green tea drinking were 0.52 (95% CI: 0.29-0.94) and 0.49 (95% CI: 0.31-0.77) for stomach cancer and chronic gastritis, respectively. In addition, dose-response relationships were observed with years of green tea drinking in both diseases. The results provide further support on the protective effect of green tea against stomach cancer. This is the first time that green tea drinking was found to be protective against chronic gastritis, which may be of importance when designing intervention strategies for stomach cancer and its pre-malignant lesions in the high-risk population.