Seroepidemiological Study on Upper Gastrointestical Diseases

1996 Fiscal Year Final Research Report Summary

• Project/Area Number: 06454243
• Research Category: Grant-in-Aid for General Scientific Research (B)
• Allocation Type: Single-year Grants
• Research Field: Public health/Health science
• Research Institution: Kyoto Prefectural University of Medicine
• Principal Investigator: WATANABE Yoshiyuki Kyoto Prefectural University of Medicine, Department of preventive Medicine, Associate Professor, 医学部, 助教授 (00191809)
• Co-Investigator(Kenkyū-buntansha): KAWAI Keiichi Kyoto Prefectural University of medicine, Department of preventive Medicine, Pro, 医学部, 名誉教授 (50079745)
• Project Period (FY): 1994 – 1995
• Keywords: gastric cancer / atrophic gastritis / Helicobacter pylori / epidemiolgy

Research Abstract

We conducted a seroepidemiological nested case-control study to determine the association of gastric cancer with Helicobacter pylori infection and atrophic gastritis. A cohort of 2,858 participants in an annual multiphasic health check-up were followed for 8 years. Data for 45 gastric cancer cases and 225 sex, age and address matched control subjects were analyzed. Helicobacter pylori infecction was determined by IgG antibodies, and atrophic gastritis was diagnosed by both serum pepsinogen I level (<=70 ng/ml) and the pepsinogen I/II ratio (<=3.0). Univariate analysis showed that Helicobacter pylori and atrophic gastritis were significantly associated with gastric cancer. In a multivariate analysis, atrophic gastritis was associated with significantly increased risk of cancer (odds ratio, 3.38 ; 95% confidence interval, 1.54-7.42) ; however, Helicobacter pylori was not associated with cancer (odds ratio, 1.84 ; 95% confidence interval, 0.59-5.72). We also conducted a seroepidemiologica l cohort study using the Cox Regression model to determine the association of gastric cancer with Helicobacter pylori infection and atrophic gastritis. From a cohort of 2,858 participants in an annual multiphasic health check-up were followed for about 7.5 years. Among the participants, 295 were died, 46 moved to other areas and 45 were diagnosed as gastric cancer by the end of study period. Helicobacter pylori infection and atrophic gastritis were diagnosed by the same methods as nested case-control study. Univariate analysis showed that Helicobacter pylori and atrophic gastritis were significantly associated with gastric cancer. In a multivariate analysis, atrophic gastritis was associated with significantly increased risk of cancer (hazard ratio, 4.01 ; 95% confidence interval, 1.94-8.29) ; however, Helicobacter pylori was not associated with cancer (hazard ratio, 1.56 ; 95% confidence interval, 0.52-4.67). These results suggest that Helicobacter pylori infection alone is not directly associated with gastric carcinogenesis, but has an indirect relation to gastric cancer through the development of atrophic gastritis.