Abstract:
BACKGROUND AND AIMS:Helicobacter pylori infection and gastric atrophy are both risk factors for gastric cancer. We aimed to elucidate the natural history of gastric cancer development according to H pylori infection and gastric atrophy status. SUBJECTS AND METHODS:A total of 9293 participants in a mass health appraisal programme were candidates for inclusion in the present prospective cohort study: 6983 subjects revisited the follow up programme. Subjects were classified into four groups according to serological status at initial endoscopy. Group A (n = 3324) had "normal" pepsinogen and were negative for H pylori antibody; group B (n = 2134) had "normal" pepsinogen and were positive for H pylori antibody; group C (n = 1082) had "atrophic" pepsinogen and were positive for H pylori antibody; and group D (n = 443) had "atrophic" pepsinogen and were negative for H pylori antibody. Incidence of gastric cancer was determined by annual endoscopic examination. RESULTS:Mean duration of follow up was 4.7 years and the average number of endoscopic examinations was 5.1. The annual incidence of gastric cancer was 0.04% (95% confidence interval (CI) 0.02-0.09), 0.06% (0.03-0.13), 0.35% (0.23-0.57), and 0.60% (0.34-1.05) in groups A, B, C, and D, respectively. Hazard ratios compared with group A were 1.1 (95% CI 0.4-3.4), 6.0 (2.4-14.5), and 8.2 (3.2-21.5) in groups B, C, and D, respectively. Age, sex, and "group" significantly served as independent valuables by multivariate analysis. CONCLUSIONS:The combination of serum pepsinogen and anti-H pylori antibody provides a good predictive marker for the development of gastric cancer.
journal_name
Gutjournal_title
Gutauthors
Watabe H,Mitsushima T,Yamaji Y,Okamoto M,Wada R,Kokubo T,Doi H,Yoshida H,Kawabe T,Omata Mdoi
10.1136/gut.2004.055400keywords:
subject
Has Abstractpub_date
2005-06-01 00:00:00pages
764-8issue
6eissn
0017-5749issn
1468-3288pii
54/6/764journal_volume
54pub_type
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