H.Pylori
Copyright ©The Author(s) 2002. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 15, 2002; 8(6): 1103-1107
Published online Dec 15, 2002. doi: 10.3748/wjg.v8.i6.1103
Helicobacter pylori infection and gastric cancer: evidence from a retrospective cohort study and nested case-control study in China
Run-Tian Wang, Tao Wang, Kun Chen, Ji-Yao Wang, Jie-Ping Zhang, San-Ren Lin, Yi-Min Zhu, Wen-Ming Zhang, Yu-Xin Cao, Chou-Wen Zhu, Hai Yu, Yu-Jun Cong, Shu Zheng, Bing-Quan Wu
Run-Tian Wang, Tao Wang, Jie-Ping Zhang, San-Ren Lin, Bing-Quan Wu, Health Science Center, Peking University, Beijing 100083, China
Kun Chen, Yi-Min Zhu, Shu Zheng, School of Medicine, Zhejiang University, Hangzhou 310031, Zhejiang Province, China
Ji-Yao Wang, Chou-Wen Zhu, Zhongshan Hospital, Fundan University, Shanghai 200032, China
Wen-Ming Zhang, The First People’s Hospital of Changzhou, Changzhou 213003, Jiangsu Province, China
Yu-Xin Cao, The First People’s Hospital of Muping, Yantai 264100, Shandong Province, China
Yu-Jun Cong, The Third People’s Hospital of Muping, Yantai 264107, Shandong Province, China
Author contributions: All authors contributed equally to the work.
Supported by Chinese Medical Board of New York,Inc.,No.96-628
Correspondence to: Run-Tian Wang, Prof., Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing, 100083, China. twang@bjmu.edu.cn
Telephone: +86-10-62091525 Fax: +86-10-62015583
Received: April 29, 2002
Revised: June 4, 2002
Accepted: June 12, 2002
Published online: December 15, 2002
Abstract

AIM: To explore the association between Helicobacter pylori (Hp) infection and risk of gastric cancer in China.

METHODS: Utilizing gastroendoscopic biospsy tissue banks accumulated from1980 to1988 in Shandong, Zhejiang, and Jiangsu, where stomach cancer incidence was high, during stomach cancer screening conducted by Health Science Center of Peking University, School of Medicine of Zhejiang University, and Zhongshan Hospital of Fudan University. Warthin Starry silver staining method was applied to determine H. pylori infection status of biopsies collected during gastroendoscopic examination. In the retrospective study, the subjects were divided into two cohorts, the exposure cohort was positive H. pylori infection, and the non-exposure cohort was negative. Death from stomach cancer was determined as the outcome of the study. Logistic regression and Cox regression were applied to analyze the association between Helicobacter pylori infection and gastric cancer risk. In the nested case-control study, there were 28 deaths from gastric cancer in the fields of Muping, Shandong province, and Zhoushan, Zhejiang provinces. 4 controls were matched to each case on the basis of age ( ± 5 years old), sex, residential place at the same time entered into the study. Conditional logistic regression analysis was used to analyze the data.

RESULTS: There were a total of 2719 subjects (male 1399, female 1320) with gastroendoscopic biopsies stored available treated as a cohort. H. pylori positive cohort included 1671 subjects (61.5%) and H. pylori negative cohort 1048 subjects(38.5%). These subjects were followed up for 1-19 years, averaged 10.88 years. The outcome of death from stomach cancer in the exposure cohort was 33, and in the non-exposure cohort 11. After adjustment for age and sex, RR = 1.9850 (P = 0.0491), 95%CI was 1.0026, and 3.9301. The results of conditional logistic regression showed an OR of 4.467 and 95%CI of 1.161, and 17.190 for the nested case control study.

CONCLUSION: The results from the retrospective cohort study and the nested-case control study on the association of H. pylori infection and gastric cancer in China suggested that Helicobacter pylori infection might increase the risk of stomach cancer.

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