根除幽门螺杆菌预防胃癌:希望和困惑

Eradication of Helicobacter pylori for Prevention of Gastric Cancer: Hope and Perplexity

胃癌仍是我国最常见的恶性肿瘤之一。幽门螺杆菌感染是肠型胃癌发生的先决条件,其根除可降低胃癌发生危险性。但幽门螺杆菌感染者中最终仅<1%的患者发生胃癌,环境因素和遗传因素在一些患者中起重要作用。根除幽门螺杆菌作为胃癌一级预防策略已被提出。但是,是普遍筛查幽门螺杆菌感染和治疗所有阳性者,还是根据当地条件,在评估可行性、疗效和不良反应后进行实施尚有争议。基于我国情况,当前似乎采取后一种策略更加妥当。

Gastric cancer is one of the most common malignancies in our country. Helicobacter pylori （Hp） infection is a prerequisite for intestinal type gastric cancer, and eradication of Hp can reduce the risk of gastric cancer. However, gastric cancer is finally developed only in less than 1% of subjects with Hp infection. Environmental factors and genetic factors play an important role in some of the patients. Eradication of Hp for prevention of gastric cancer as a primary prevention strategy has been proposed. However, whether we should carry out population-based screening for Hp infection and treat all the positive cases or implementing this strategy in accordance with local conditions after assessing the feasibility, efficacy and adverse reactions remains to be controversial. Based on the conditions in our country, at present, the latter seems to be more appropriate.