AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvin...AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvince.The primary gastric cancer cases werehistologically confirmed or diagnosed by surgerybetween,January 1996 and March 1998.Healthycontrols were randomly selected and matched byage,sex,and neighborhood of residence.Atotal of 101 pairs were included in the study.Specially trained interviewers conducted face-to-face interviews with the subjects according toa standardized questionnaire.Helicobacterpylori infections were measured by serum IgGantibody to Helicobacter pylori.ConditionalLogistic Regression analysis was used.RESULTS The presence of IgG antibody toHelicobacter pylori was 63.7% in studysubjects,56.0% in patients with cardiac cancer,and 60.5% in patients with non-cardiac gastriccancer.The risk factors of gastric cancer inChangle County were identified such as loweducational level[OR=3.864;95% confidenceinterval(95% CI)1.604-9.311],lowconsumption of fresh vegetables(OR=4.925;95%Cl 1.356-17.885),high intake of fish sauce(OR=10.587;95% Cl 2.821-39.738),unscheduled meals(OR=4.254;95%Cl 1.445- 12.552),and Helicobacter pylori infection(OR=3.453;95%Cl 0.901-13.224).CONCLUSION Helicobacter pylori infectionmay be important in the etiology of gastriccancer,but major risk factors other thanHelicobacter pylori are responsible for the highgastric morbidity in Changle County.展开更多
AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of ...AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.展开更多
基金the Natural Science Foundation of Fujian Province,China,No.K98031
文摘AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvince.The primary gastric cancer cases werehistologically confirmed or diagnosed by surgerybetween,January 1996 and March 1998.Healthycontrols were randomly selected and matched byage,sex,and neighborhood of residence.Atotal of 101 pairs were included in the study.Specially trained interviewers conducted face-to-face interviews with the subjects according toa standardized questionnaire.Helicobacterpylori infections were measured by serum IgGantibody to Helicobacter pylori.ConditionalLogistic Regression analysis was used.RESULTS The presence of IgG antibody toHelicobacter pylori was 63.7% in studysubjects,56.0% in patients with cardiac cancer,and 60.5% in patients with non-cardiac gastriccancer.The risk factors of gastric cancer inChangle County were identified such as loweducational level[OR=3.864;95% confidenceinterval(95% CI)1.604-9.311],lowconsumption of fresh vegetables(OR=4.925;95%Cl 1.356-17.885),high intake of fish sauce(OR=10.587;95% Cl 2.821-39.738),unscheduled meals(OR=4.254;95%Cl 1.445- 12.552),and Helicobacter pylori infection(OR=3.453;95%Cl 0.901-13.224).CONCLUSION Helicobacter pylori infectionmay be important in the etiology of gastriccancer,but major risk factors other thanHelicobacter pylori are responsible for the highgastric morbidity in Changle County.
文摘AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.
