胃癌高发地区40~69岁人群幽门螺旋杆菌感染与胃部疾病关联分析  

Analysis of Helicobacter pylori infection and its association with gastric diseases among a population aged 40-69 years in areas with high incidence of gastric cancer

作　　者：朱进华 冯祥[3] 华召来 施秋平[3] 印红军 周金意[5] 施瑞华[1,2] ZHU Jinhua;FENG Xiang;HUA Zhaolai;SHI Qiuping;YIN Hongjun;ZHOU Jinyi;SHI Ruihua(Department of Gastroenterology,Zhongda Hospital Affiliated to Southeast University,Nanjing 210000,China;Medical College,Southeastern University,Nanjing 210000,China;Peoples Hospital of Yangzhong City,Yangzhong 212200,China;Department of Noncommunicable Disease Prevention,Jiangsu Center for Disease Control and Prevention,Nanjing,210009,China)

机构地区：[1]东南大学附属中大医院消化科,江苏南京210000 [2]东南大学医学院,江苏南京210000 [3]扬中市人民医院肿瘤防治研究所,江苏扬中212200 [4]扬中市人民医院内镜中心,江苏扬中212200 [5]江苏省疾病预防控制中心慢性病防制所,江苏南京210009

出　　处：《中华肿瘤防治杂志》2023年第13期765-772,共8页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家重点研发计划(2016YFC0901400,2016YFC1302800);扬中市重点研发计划(YS202005);镇江市重点研发计划(SH2022051)。

摘　　要：目的 分析扬中市40~69岁人群中幽门螺旋杆菌(H.pylori)的感染情况及其与胃癌及癌前疾病/病变的关联。方法 将2017-11-20-2021-06-08在扬中市人民医院参与上消化道癌筛查的6 751名40~69岁居民作为调查对象。所有对象均接受流行病学调查、内窥镜检查、指示性活检、快速尿素酶检测和组织病理学检查。采用二项式logistic回归分析H.pylori感染的影响因素,采用多元有序logistic回归评估H.pylori与胃癌及癌前疾病/病变的关联。结果 在6 751名40~69岁调查对象中,H.pylori感染率为43.2%(2 916名),胃癌及癌前疾病/病变检出率为39.5%(2 668名)。二项式logistic回归分析结果显示,男性(OR=1.278,95%CI为1.152~1.416)、初中教育程度(OR=1.157,95%CI为1.037~1.290)、进食速度过快(OR=1.132,95%CI为1.014~1.264)和有癌症家族史(OR=1.146,95%CI为1.035~1.268)是H.pylori感染的独立危险因素。多元有序logistic回归结果显示,H.pylori感染(OR=1.806,95%CI为1.635~1.995)与胃癌及癌前疾病/病变的高患病风险有关联。此外,性别、年龄、教育程度、BMI和吸烟状况也与胃癌及癌前疾病/病变有关联,均P<0.05。结论 扬中市40~69岁人群H.pylori感染率处于中等水平,且与性别、教育程度、进食速度和癌症家族史有关联。H.pylori会增加胃癌及癌前疾病/病变的患病风险。因此,在积极倡导培养良好卫生及饮食习惯预防H.pylori感染的同时,还应加强对H.pylori感染的定期监测和干预,避免其持续危害胃部健康。Objective To analyse Helicobacter pylori(H.pylori)infection in the population aged 40-69 in Yangzhong City and determine its association with gastric cancer(GC)and precancerous diseases/lesions.Methods Totally 6751 residents aged 40-69 who participated in upper digestive tract cancer screening in Yangzhong People's Hospital from November 20,2017 to June 8,2021 were investigated.All participants received epidemiological investigation,endoscopy,indicative biopsy,rapid urease detection,and histopathological examination.Binomial logistic regression was used to explore the influencing factors of Pylori infection.Meanwhile,multiple ordinal logistic regression was used to assess the association between H.pylori and GC and precancerous diseases/lesions.Results Of all respondents,the infection rate of pylori was 43.2%(2916 cases),and the detection rate of GC and precancerous diseases/lesions was 39.5%(2668 cases).The results of binomial logistic regression analysis showed that males(OR=1.278,95%CI=1.152-1.416),the education level of junior high school(OR=1.157,95%CI=1.037-1.290),eating too fast(OR=1.132,95%CI=1.014-1.264)and family history of cancer(OR=1.146,95%CI=1.035-1.268)were the independent risk factors of H.pylori.The multiple ordinal logistic regression results showed that H.pylori(OR=1.806,95%CI=1.635-1.995)was significantly associated with a high risk of GC and precancerous diseases/lesions.Furthermore,gender,age,education,BMI,and smoking status were significantly associated with GC and precancerous diseases/lesions(all P<0.05).Conclusions The infection rate of H.pylori among the population aged 40-69in Yangzhong City is at a medium level and is related to gender,education level,eating speed,and family history of cancer.H.pylori can increase the risk of GC and precancerous diseases/lesions.Therefore,while actively advocating good hygiene and eating habits to prevent H.pyloriinfection,we should also strengthen its regular monitoring and intervention to avoid its continuous harm to stomach health.

关 键 词：幽门螺旋杆菌 高发地区 胃癌 癌前疾病/病变 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]