已知幽门螺杆菌(HP)与肠道癌变有关。至于肝胆肿瘤,很少有不一致的报告。我们在一项大型队列研究中调查了HP感染及其与肝胆肿瘤发病率的关系。该队列对该目的的适当性是通过其识别与胃癌的既定风险关系的能力来衡量的。
■这项历史研究是在丹麦中部地区进行的。在通过尿素呼气试验测试HP感染后,包括来自初级医疗保健的患者。病人诊断,年龄,性别,和出生国是从丹麦国家行政登记处获得的。Cox回归比较HP阳性和HP阴性者肝胆管和胃癌的发生率。调整混杂变量。
■共纳入53,633人,10,553人被检测为HP阳性。他们被跟踪的中位数为4.6年(总计250,515人年)。我们发现了64例肝胆肿瘤,HP阳性患者的发生率明显较低;HR=0.27(95%CI0.11-0.68)。证实HP阳性人群中胃癌的发病率较高(HR=1.99(95%CI1.35-2.94))。
■在调整年龄后,HP感染者的肝胆肿瘤发病率明显降低,性别,肝硬化,与酒精有关的诊断,慢性病毒性肝炎,和原产国。我们没有发现这个意外发现的方法论原因,感染和癌症之间的致病联系仍有待确定。我们的结果必须在类似的队列中得到证实。
UNASSIGNED: Helicobacter pylori (HP) is known to be involved in intestinal carcinogenesis. As regards hepatobiliary cancers, there are few and inconsistent reports. We investigated HP infection and its association with the incidence of hepatobiliary cancers in a large cohort study. The cohort\'s appropriateness for the purpose was gauged by its ability to identify the established risk relation to gastric cancer.
UNASSIGNED: This historical study was performed in the Central Denmark Region. Patients were included from primary healthcare after being tested for HP infection with a urea breath test. Patients\' diagnoses, age, gender, and country of birth were obtained from Danish national administrative registries. Cox regression was used to compare incidences of hepatobiliary and gastric cancer between HP-positive and HP-negative persons, adjusting for confounding variables.
UNASSIGNED: A total of 53,633 persons were included and 10,553 were tested HP-positive. They were followed for a median of 4.6 years (total 250,515 person-years). We found 64 hepatobiliary cancers, with a markedly lower incidence in HP-positive persons; HR = 0.27 (95% CI 0.11-0.68). A higher incidence of gastric cancer in HP-positive persons was confirmed (HR = 1.99 (95% CI 1.35-2.94)).
UNASSIGNED: The incidence of hepatobiliary cancers was remarkably lower in HP-infected persons after adjusting for age, gender, cirrhosis, alcohol-related diagnoses, chronic viral hepatitis, and country of origin. We found no methodological cause for this unexpected finding, and the pathogenic links between the infection and cancer remain to be identified. Our results must be confirmed in a similar cohort.