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한 농촌지역 주민에서 성, 연령 및 Helicobacter pylori 감염 여부에 따른 위축성 위염과 장상피화생 유병률

The Prevalence of Atrophic Gastritis and Intestinal Metaplasia according to Gender, Age and Helicobacter Pylori Infection in a Rural Population

은창수|한동수|송규상|김용성|최보율|김현자|변태준
대한예방의학회 (The Korean Society For Preventive Medicine)|2008.11|예방의학회지 (Journal of Preventive Medicine and Public Health)|제41권 제6호|pp. 373-379

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참고문헌

키워드

KoreaPrevalenceHelicobacter pyloriMetaplasiaAtrophic gastritis
주제분류예방의학/직업환경의학

초록

Objectives : The objective of this study was to evaluate the prevalence of atrophic gastritis and intestinal metaplasia according to gender, age and Helicobacter pylori infection in a rural population in Korea. Methods: Between April 2003 and January 2007, 713 subjects (298 men and 415 women, age range: 18-85) among the 2,161 adults who participated in a populationbased survey received gastrointestinal endoscopy. All the subjects provided informed consent. Multiple biopsy specimens were evaluated for the presence of atrophic gastritis and intestinal metaplasia. The presence of Helicobacter pylori was determined using CLO and histology testing. Results : The age-adjusted prevalence of atrophic gastritis was 42.7% for men and 38.1% for women and the prevalence of intestinal metaplasia was 42.5% for men and 32.7% for women. The prevalence of atrophic gastritis and intestinal metaplasia increased significantly with age for both men and women (p for trend<0.001). The ageadjusted prevalence of Helicobacter pylori was similar for men (59.0%) and women (56.7%). The subjects with Helicobacter pylori infection showed a significantly higher prevalence of intestinal metaplasia (44.3%) compared with that (26.8%) of the noninfected subjects (p<0.001). However, the prevalence of atrophic gastritis was not statistically different between the Helicobacter pyloriinfected subjects and the noninfected individuals. Conclusions : Our findings suggest that the prevalence of atrophic gastritis and intestinal metaplasia is higher for a Korean rural population than that for a Western population; this may be related to the high incidence of gastric cancer in Koreans. Especially, the prevalence of intestinal metaplasia was high for the subjects with Helicobacter pylori infection. The multistep process of gastric carcinogenesis and the various factors contributing to each step of this process need to be determined by conducting future follow-up studies.

Abstract

Objectives : The objective of this study was to evaluate the prevalence of atrophic gastritis and intestinal metaplasia according to gender, age and Helicobacter pylori infection in a rural population in Korea. Methods: Between April 2003 and January 2007, 713 subjects (298 men and 415 women, age range: 18-85) among the 2,161 adults who participated in a populationbased survey received gastrointestinal endoscopy. All the subjects provided informed consent. Multiple biopsy specimens were evaluated for the presence of atrophic gastritis and intestinal metaplasia. The presence of Helicobacter pylori was determined using CLO and histology testing. Results : The age-adjusted prevalence of atrophic gastritis was 42.7% for men and 38.1% for women and the prevalence of intestinal metaplasia was 42.5% for men and 32.7% for women. The prevalence of atrophic gastritis and intestinal metaplasia increased significantly with age for both men and women (p for trend<0.001). The ageadjusted prevalence of Helicobacter pylori was similar for men (59.0%) and women (56.7%). The subjects with Helicobacter pylori infection showed a significantly higher prevalence of intestinal metaplasia (44.3%) compared with that (26.8%) of the noninfected subjects (p<0.001). However, the prevalence of atrophic gastritis was not statistically different between the Helicobacter pyloriinfected subjects and the noninfected individuals. Conclusions : Our findings suggest that the prevalence of atrophic gastritis and intestinal metaplasia is higher for a Korean rural population than that for a Western population; this may be related to the high incidence of gastric cancer in Koreans. Especially, the prevalence of intestinal metaplasia was high for the subjects with Helicobacter pylori infection. The multistep process of gastric carcinogenesis and the various factors contributing to each step of this process need to be determined by conducting future follow-up studies.

참고문헌 (38)

  1. Korea National Statistical Office, "Annual Report on the Cause of Death Statistics in 2006" (2007), Korea National Statistical Office
  2. Hai-Rim Shin, "Cancer Incidence in Korea", Cancer Research and Treatment, 34(6), pp.405~408 (2002), 대한암학회
  3. Lauren P, "The two histological main types of gastric carcinoma: Diffuse and so-called intestinal-type carcinoma, An attempt at a histoclinical classification", Acta Pathol Microbiol Scand
  4. Correa P, "Human gastric carcinogenesis: a multistep and multifactorial process: First American cancer society award lecture on cancer epidemiology and prevention", Cancer Res, 52(24), pp.6735~6740 (1992)
  5. Classification and grading of gastritis. The updated Sydney system, "Classification and grading of gastritis, The updated Sydney system", Am J Surg Pathol, 20(10), pp.1161~1181 (1996)
  6. Lauwers GY, "Defining the pathologic diagnosis of metaplasia, atrophy, dysplasia, and gastric adenocarcinoma", J Clin Gastroenterol, 36(5), pp.37~43 (2003)
  7. Hartwell L, "Cancer biomarkers: A systems approach", Nat Biotechnol, 24(8), pp.905~908 (2006)
  8. Kuipers EJ, "Longterm sequelae of Helicobacter pylori gastritis", Lancet, 345(8964), pp.1525~1528 (1995)
  9. Zhang L, "Helicobacter pylori antibodies in relation to precancerous gastric lesions in a high-risk Chinese population", Cancer Epidemiol Biomarkers Prev, 5(8), pp.627~630 (1996)
  10. Ohkuma K, "Association of Helicobacter pylori infection with atrophic gastritis and intestinal metaplasia", J Gastroenterol Hepatol, 15(10), pp.1105~1112 (2000)
  11. Asaka M, "Atrophic gastritis and intestinal metaplasia in Japan: Results of a large multicenter study", Helicobacter, 6(4), pp.294~299 (2001)
  12. Korean H, "Diagnosis and treatment of Helicobacter pylori infection in Korea", Korean J Gastroenterol, 32(3), pp.275~289 (1998)
  13. International Agency for Research on Cancer, "Schistosomes, Liver Flukes and Helicobacter Pylori", pp.177~240 (1994), WHO
  14. Coma del Corral MJ, "Risk of cancer in patients with gastric dysplasia. Follow-up study of 67 patients", Cancer, 65(9), pp.2078~2085 (1990)
  15. Inoue M, "Severity of chronic atrophic gastritis and subsequent gastric cancer occurrence: A 10-year prospective cohort study in Japan", Cancer Lett, 161(1), pp.105~112 (2000)
  16. Ohata H, "Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer", Int J Cancer, 109(1), pp.138~143 (2004)
  17. de Vries AC, "Gastric cancer risk in patients with premalignant gastric lesions: A nationwide cohort study in the Netherlands", Gastroenterology, 134(4), pp.945~952 (2008)
  18. Borch K, "Prevalence of gastroduodenitis and Helicobacter pylori infection in a general population sample: Relations to symptomatology and life-style", Dig Dis Sci, 45(7), pp.1322~1329 (2000)
  19. You WC, "Precancerous lesions in two counties of China with contrasting gastric cancer risk", Int J Epidemiol, 27(6), pp.945~948 (1998)
  20. Namekata T, "Chronic atrophic gastritis and Helicobacter pylori infection among Japanese Americans in Seattle", Am J Epidemiol, 151(8), pp.820~830 (2000)
  21. Dunn JE, "Cancer epidemiology in populations of the United States--with emphasis on Hawaii and California--and Japan", Cancer Res, 35, pp.3240~3245 (1975)
  22. Kim JH, "Seroepidemiological study of Helicobacter pylori infection in asymptomatic people in South Korea", J Gastroenterol Hepatol, 16(9), pp.969~975 (2001)
  23. Yim JY, "Seroprevalence of Helicobacter pylori in South Korea", Helicobacter, 12(4), pp.333~340 (2007)
  24. Choi KH, "Prevalence of Helicobacter pylori infection among Korean adults in Pusan", Korean J Gastroenterol, 28(6), pp.758~763 (1996)
  25. Song JB, "Seroprevalence of Helicobacter pylori infection in patients without gastric symptoms", Korean J Gastroenterol, 29(2), pp.310~316 (1997)
  26. 김나영, "Helicobacter pylori 감염 역학 및 감염 경로", 대한소화기학회지, 46(3), pp.153~158 (2005), 대한소화기학회
  27. Replogle ML, "Increased risk of Helicobacter pylori associated with birth in wartime and post-war Japan", Int J Epidemiol, 25(1), pp.210~214 (1996)
  28. Farinati F, "Prevalence of Helicobacter pylori infection in patients with precancerous changes and gastric cancer", Eur J Cancer Prev, 2(4), pp.321~326 (1993)
  29. Asaka M, "Atrophic changes of gastric mucosa are caused by Helicobacter pylori infection rather than aging: Studies in asymptomatic Japanese adults", Helicobacter, 1(1), pp.52~56 (1996)
  30. Wong BC, "Helicobacter pylori eradication to prevent gastric cancer in a highrisk region of China: A randomized controlled trial", JAMA, 291(2), pp.187~194 (2004)
  31. 이용구, "Helicobacter pylori 제균 후 위축위염과 장상피화생의 변화", 대한소화기학회지, 50(5), pp.299~305 (2007), 대한소화기학회
  32. 이용구, "Helicobacter pylori 제균 후 위축위염과 장상피화생의 변화", 대한소화기학회지, 50(5), pp.299~305 (2007), 대한소화기학회
  33. Hojo M, "Alteration of histological gastritis after cure of Helicobacter pylori infection", Aliment Pharmacol Ther, 16(11), pp.1923~1932 (2002)
  34. Kim N, "Helicobacter pylori infection and development of gastric cancer in Korea: Longterm follow-up", J Clin Gastroenterol, 42(5), pp.448~454 (2008)
  35. Miwa H, "pylori and gastric cancer: The Asian enigma", Am J Gastroenterol, 97(5), pp.1106~1112 (2002)
  36. Correa P, "Chemoprevention of gastric dysplasia: Randomized trial of antioxidant supplements and anti-helicobacter pylori therapy", J Natl Cancer Inst, 92(23), pp.1881~1888 (2000)
  37. Russo A, "Effect of lifestyle, smoking, and diet on development of intestinal metaplasia in H. pylori-positive subjects", Am J Gastroenterol, 96(5), pp.1402~1408 (2001)
  38. El-Omar EM, "The importance of interleukin 1beta in Helicobacter pylori associated disease", Gut, 48(6), pp.743~747 (2001)

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