摘要
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?
BACKGROUND & OBJECTIVE: Researches show that epidemiologic factors of gastric cancer include living habit, eating moldy food and pickles, dystrophy, lack of microelements, and inherit, etc. This study was to explore universalities of these factors in Wuwei, a city in northwest China with high incidence of gastric cancer, and provide evidences for the first-prevention of gastric cancer. METHODS: Family histories of the residents in Wuwei City were investigated with case-control method. Separating ratio and heredity degree of gastric cancer were calculated with Li-Mantel-Cart method and Falconer's regression method. Chronic gastritis patients were followed-up by home-visit, gastroscopy, and pathology. Cancerigenic fungi and volatility N-nitrosate compounds in residents' meal, Helicobacter pylori (Hp) in gastric mucosa, and total content of vitamin C in 293 healthy adults' serum were detected by culture, authentication, and laboratory examinations. RESULTS: In Wuwei City, the separating ratio of gastric cancer was 0.077; the heredity degree of first-degree relatives was 22.91%; cancerization rate of year in person of atrophic gastritis crowd was 1.09%. Eight kinds of nitrosamine and 14 kinds of cancerigenic fungi were detected from residents' meal. Total content of vitamin C in serum of the 293 healthy adults in summer was (5.74+2.79) mg/L. Positive rate of Hp in gastric mucosa of the residents was 67%. CONCLUSION: The major extrinsic factors of gastric cancer in Wuwei City include various strong carcinogens existing in residents' meal and lack of vitamin C; its intrinsic factors include infection of Hp, atrophic gastritis (especially atypical hyperplasia), and heritage susceptibility.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2005年第5期563-566,共4页
Chinese Journal of Cancer
关键词
胃肿瘤/流行病学
危险因素
慢性萎缩性胃炎
幽门螺杆菌
多基因遗传
Stomach neoplasms/Epidemiology
Risk factor
Chronic atrophic gastritis
Helicobacter pylori
Multi-genes inherit
