日本北海道大學(xué)的一項研究顯示,，早期胃癌患者在常規(guī)治療時，服用針對幽門螺桿菌的除菌藥物能使胃癌復(fù)發(fā)率降低近三分之二,。有關(guān)研究成果發(fā)表在新一期英國醫(yī)學(xué)雜志《柳葉刀》（The Lancet）上,。
據(jù)日本《朝日新聞》網(wǎng)站報道，日本北海道大學(xué)的淺香正博教授等人在征得了約500名早期胃癌患者同意后,，對他們進(jìn)行了測試,。在進(jìn)行常規(guī)治療時，研究者只讓一半患者服用對付幽門螺桿菌的除菌藥,。3年后,，服除菌藥的一組中有9人胃癌復(fù)發(fā)，另一組中則有24人胃癌復(fù)發(fā),。
研究人員因此得出結(jié)論,，除菌藥能使胃癌復(fù)發(fā)率降低近三分之二。但報道沒有說明除菌藥的具體成分,。
據(jù)報道,，幽門螺桿菌對胃黏膜的持續(xù)感染，與胃炎,、胃潰瘍和胃癌的發(fā)病密切相關(guān),。超過90%的十二指腸潰瘍和80%左右的胃潰瘍由幽門螺桿菌引起。（生物谷Bioon.com）
生物谷推薦原始出處：
The Lancet 2008; 372:392-397,；DOI:10.1016/S0140-6736(08)61159-9
Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial
Kazutoshi Fukase MD a, Mototsugu Kato MD b, Shogo Kikuchi MD c, Kazuhiko Inoue MD d, Naomi Uemura MD e, Shiro Okamoto MD f, Shuichi Terao MD g, Kenji Amagai MD h, Shunji Hayashi MD i and Dr Masahiro Asaka MD j , for the Japan Gast Study Group
Summary
Background
The relation between Helicobacter pylori infection and gastric cancer has been proven in epidemiological studies and animal experiments. Our aim was to investigate the prophylactic effect of H pylori eradication on the development of metachronous gastric carcinoma after endoscopic resection for early gastric cancer.
Methods
In this multi-centre, open-label, randomised controlled trial, 544 patients with early gastric cancer, either newly diagnosed and planning to have endoscopic treatment or in post-resection follow-up after endoscopic treatment, were randomly assigned to receive an H pylori eradication regimen (n=272) or control (n=272). Randomisation was done by a computer-generated randomisation list and was stratified by whether the patient was newly diagnosed or post-resection. Patients in the eradication group received lansoprazole 30 mg twice daily, amoxicillin 750 mg twice daily, and clarithromycin 200 mg twice daily for a week; those in the control group received standard care, but no treatment for H pylori. Patients were examined endoscopically at 6, 12, 24, and 36 months after allocation. The primary endpoint was diagnosis of new carcinoma at another site in the stomach. Analyses were by intention to treat. This trial is registered with the UMIN Clinical Trials Registry, number UMIN000001169.
Findings
At 3-year follow-up, metachronous gastric carcinoma had developed in nine patients in the eradication group and 24 in the control group. In the full intention-to-treat population, including all patients irrespective of length of follow-up (272 patients in each group), the odds ratio for metachronous gastric carcinoma was 0·353 (95% CI 0·161–0·775; p=0·009); in the modified intention-to-treat population, including patients with at least one post-randomisation assessment of tumour status and adjusting for loss to follow-up (255 patients in the eradication group, 250 in the control group), the hazard ratio for metachronous gastric carcinoma was 0·339 (95% CI 0·157–0·729; p=0·003). In the eradication group, 19 (7%) patients had diarrhoea and 32 (12%) had soft stools.
Interpretation
Prophylactic eradication of H pylori after endoscopic resection of early gastric cancer should be used to prevent the development of metachronous gastric carcinoma.
Funding
Hiroshima Cancer Seminar Foundation.
