日本北海道大学的一项研究显示，早期胃癌患者在常规治疗时，服用针对幽门螺杆菌的除菌药物能使胃癌复发率降低近三分之二。有关研究成果发表在新一期英国医学杂志《柳叶刀》（The Lancet）上。
据日本《朝日新闻》网站报道，日本北海道大学的浅香正博教授等人在征得了约500名早期胃癌患者同意后，对他们进行了测试。在进行常规治疗时，研究者只让一半患者服用对付幽门螺杆菌的除菌药。3年后，服除菌药的一组中有9人胃癌复发，另一组中则有24人胃癌复发。
研究人员因此得出结论，除菌药能使胃癌复发率降低近三分之二。但报道没有说明除菌药的具体成分。
据报道，幽门螺杆菌对胃黏膜的持续感染，与胃炎、胃溃疡和胃癌的发病密切相关。超过90%的十二指肠溃疡和80%左右的胃溃疡由幽门螺杆菌引起。（生物谷Bioon.com）
生物谷推荐原始出处：
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.
