在我国胃癌高发区通过根除Hp预防胃癌发生：一项RCT研究
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目录
Helibobacter pylori
eradication to prevent gastric cancer in a high-risk region of China：A Randomized Controlled Trial
目录
CONTEXT
Although chronic Helicobacter pylori infection is associated with gastric cancer, the effect of H pylori treatment on prevention of gastric cancer development in chronic carriers is unknown.
Thanks for your attention!
目录
目录
RESULTS
ቤተ መጻሕፍቲ ባይዱ
Smoking (hazard ratio [HR], 6.2; 95% confidence interval [CI], 2.3-16.5; P<.001) and older age (HR, 1.10; 95% CI, 1.05-1.15; P<.001) were independent risk factors for the development of gastric cancer in this cohort.
目录
RESEULTS
Among the 18 new cases of gastric cancers that developed, no overall reduction was observed in participants who received H pylori eradication treatment (n = 7) compared with those who did not (n = 11) (P =.33). In a subgroup of patients with no precancerous lesions on presentation, no patient developed gastric cancer during a follow-up of 7.5 years after H pylori eradication treatment compared with those who received placebo (0 vs 6; P =.02).
目录
INTERVENTION
Patients were randomly assigned to receive H pylori eradication treatment: a 2-week course of omeprazole, 20 mg, a combination product of amoxicillin and clavulanate potassium, 750 mg, and metronidazole, 400 mg, all twice daily (n = 817); or placebo (n = 813).
目录
Wong BC, Lam SK, Wong WM, Chen JS, Zheng TT, Feng RE, Lai KC, Hu WH, Yuen ST, Leung SY, Fong DY, Ho J, Ching CK, Chen JS; China Gastric Cancer Study Group. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 2004. 291(2):187-94. 目录
目录
结论
4.
5.
6.
我们发现,在中国的一个高胃癌高发区，在为 期7.5年的随访期间，在接受Hp根除治疗的 受试者和那些接受安慰剂的受试者中，胃癌 的发病率在人口学水平上是相似。 在没有癌前病变的Hp感染者中,根除Hp可以 显著降低胃癌的发生。 进一步的研究探讨，在已经出现了癌前病变 的受试者中根除Hp的作用是必要的。
目录
CONCLUSIONS
We found that the incidence of gastric cancer development at the population level was similar between participants receiving H pylori eradication treatment and those receiving placebo during a period of 7.5 years in a highrisk region of China.
目录
MAIN OUTCOME MEASURES
The primary outcome measure was incidence of gastric cancer during follow-up, compared between H pylori eradication and placebo groups. The secondary outcome measure was incidence of gastric cancer in patients with or without precancerous lesions, compared between the 2 groups.
在我国胃癌高发区通过根除Hp预防胃 癌的发生：一项RCT研究
目录
研究背景
虽然幽门螺杆菌慢性感染与胃癌有关,在Hp 慢性感染的携带者中进行除菌治疗对防治 胃癌的发展中所起的作用仍是未知的。
目录
研究目的
确定根除Hp治疗是否会降低胃癌的发 病率。
目录
试验设计
该项前瞻性、随机、安慰剂对照,以人群为 基础的初级预防研究共招募了1630名Hp感 染的健康携带者，他们均来自中国福建省 。研究时间从1994年7月持续到2002年1月 。共有988名没有癌前病变(胃萎缩、肠上 皮化生或胃不典型增生)的参与者被纳入了 本项研究。
Parsonnet J, Forman D. Helicobacter pylori infection and gastric cancer--for want of more outcomes. JAMA 2004. 291(2):244-5. 目录
Peek RM Jr. Eradication of Helicobacter pylori as a means towards eliminating gastric adenocarcinoma. Gastroenterology 2004. 127(1):344-6. 目录
目录
干预措施
这些受试者被随机分为Hp根除治疗组(n = 817) 和安慰剂对照组(n = 813)。Hp根除治疗组的受 试者接受为期2周的除菌治疗:奥美拉唑,20毫克, 阿莫西林和克拉霉素钾的组合产品,750毫克,和 甲硝唑,400毫克,均为每天两次口服。
目录
观察指标
主要观察指标是比较Hp根除治疗组和安 慰剂组在随访期间胃癌的发病率； 次要观察指标是比较有或无癌前病变的2 组受试者胃癌的发病率。
目录
OBJECTIVE
To determine whether treatment of H pylori infection reduces the incidence of gastric cancer.
目录
DESIGN, SETTING, AND PARTICIPANTS
Prospective, randomized, placebo-controlled, population-based primary prevention study of 1630 healthy carriers of H pylori infection from Fujian Province, China, recruited in July 1994 and followed up until January 2002. A total of 988 participants did not have precancerous lesions (gastric atrophy, intestinal metaplasia, or gastric dysplasia) on study entry.
目录
研究结果
1.
2.
3.
在18个新发现的胃癌患者中,那些接受了Hp根除 治疗的受试者(n=7)与那些没有接受除菌治疗的 受试者相比(n=11)，胃癌的发病率没有观察到 整体上的减少。 在没有癌前病变的患者中,在Hp根除治疗后7.5 年的随访时间里没有任何受试者患上胃癌，与 接受安慰剂治疗的受试者相比(0比6)。 在这个队列中，吸烟和老年是胃癌发生的独立 危险因素。
目录
CONCLUSIONS
In the subgroup of H pylori carriers without precancerous lesions, eradication of H pylori significantly decreased the development of gastric cancer. Further studies to investigate the role of H pylori eradication in participants with precancerous lesions are warranted.
Helibobacter pylori
eradication to prevent gastric cancer in a high-risk region of China：A Randomized Controlled Trial
目录
CONTEXT
Although chronic Helicobacter pylori infection is associated with gastric cancer, the effect of H pylori treatment on prevention of gastric cancer development in chronic carriers is unknown.
Thanks for your attention!
目录
目录
RESULTS
ቤተ መጻሕፍቲ ባይዱ
Smoking (hazard ratio [HR], 6.2; 95% confidence interval [CI], 2.3-16.5; P<.001) and older age (HR, 1.10; 95% CI, 1.05-1.15; P<.001) were independent risk factors for the development of gastric cancer in this cohort.
目录
RESEULTS
Among the 18 new cases of gastric cancers that developed, no overall reduction was observed in participants who received H pylori eradication treatment (n = 7) compared with those who did not (n = 11) (P =.33). In a subgroup of patients with no precancerous lesions on presentation, no patient developed gastric cancer during a follow-up of 7.5 years after H pylori eradication treatment compared with those who received placebo (0 vs 6; P =.02).
目录
INTERVENTION
Patients were randomly assigned to receive H pylori eradication treatment: a 2-week course of omeprazole, 20 mg, a combination product of amoxicillin and clavulanate potassium, 750 mg, and metronidazole, 400 mg, all twice daily (n = 817); or placebo (n = 813).
目录
Wong BC, Lam SK, Wong WM, Chen JS, Zheng TT, Feng RE, Lai KC, Hu WH, Yuen ST, Leung SY, Fong DY, Ho J, Ching CK, Chen JS; China Gastric Cancer Study Group. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 2004. 291(2):187-94. 目录
目录
结论
4.
5.
6.
我们发现,在中国的一个高胃癌高发区，在为 期7.5年的随访期间，在接受Hp根除治疗的 受试者和那些接受安慰剂的受试者中，胃癌 的发病率在人口学水平上是相似。 在没有癌前病变的Hp感染者中,根除Hp可以 显著降低胃癌的发生。 进一步的研究探讨，在已经出现了癌前病变 的受试者中根除Hp的作用是必要的。
目录
CONCLUSIONS
We found that the incidence of gastric cancer development at the population level was similar between participants receiving H pylori eradication treatment and those receiving placebo during a period of 7.5 years in a highrisk region of China.
目录
MAIN OUTCOME MEASURES
The primary outcome measure was incidence of gastric cancer during follow-up, compared between H pylori eradication and placebo groups. The secondary outcome measure was incidence of gastric cancer in patients with or without precancerous lesions, compared between the 2 groups.
在我国胃癌高发区通过根除Hp预防胃 癌的发生：一项RCT研究
目录
研究背景
虽然幽门螺杆菌慢性感染与胃癌有关,在Hp 慢性感染的携带者中进行除菌治疗对防治 胃癌的发展中所起的作用仍是未知的。
目录
研究目的
确定根除Hp治疗是否会降低胃癌的发 病率。
目录
试验设计
该项前瞻性、随机、安慰剂对照,以人群为 基础的初级预防研究共招募了1630名Hp感 染的健康携带者，他们均来自中国福建省 。研究时间从1994年7月持续到2002年1月 。共有988名没有癌前病变(胃萎缩、肠上 皮化生或胃不典型增生)的参与者被纳入了 本项研究。
Parsonnet J, Forman D. Helicobacter pylori infection and gastric cancer--for want of more outcomes. JAMA 2004. 291(2):244-5. 目录
Peek RM Jr. Eradication of Helicobacter pylori as a means towards eliminating gastric adenocarcinoma. Gastroenterology 2004. 127(1):344-6. 目录
目录
干预措施
这些受试者被随机分为Hp根除治疗组(n = 817) 和安慰剂对照组(n = 813)。Hp根除治疗组的受 试者接受为期2周的除菌治疗:奥美拉唑,20毫克, 阿莫西林和克拉霉素钾的组合产品,750毫克,和 甲硝唑,400毫克,均为每天两次口服。
目录
观察指标
主要观察指标是比较Hp根除治疗组和安 慰剂组在随访期间胃癌的发病率； 次要观察指标是比较有或无癌前病变的2 组受试者胃癌的发病率。
目录
OBJECTIVE
To determine whether treatment of H pylori infection reduces the incidence of gastric cancer.
目录
DESIGN, SETTING, AND PARTICIPANTS
Prospective, randomized, placebo-controlled, population-based primary prevention study of 1630 healthy carriers of H pylori infection from Fujian Province, China, recruited in July 1994 and followed up until January 2002. A total of 988 participants did not have precancerous lesions (gastric atrophy, intestinal metaplasia, or gastric dysplasia) on study entry.
目录
研究结果
1.
2.
3.
在18个新发现的胃癌患者中,那些接受了Hp根除 治疗的受试者(n=7)与那些没有接受除菌治疗的 受试者相比(n=11)，胃癌的发病率没有观察到 整体上的减少。 在没有癌前病变的患者中,在Hp根除治疗后7.5 年的随访时间里没有任何受试者患上胃癌，与 接受安慰剂治疗的受试者相比(0比6)。 在这个队列中，吸烟和老年是胃癌发生的独立 危险因素。
目录
CONCLUSIONS
In the subgroup of H pylori carriers without precancerous lesions, eradication of H pylori significantly decreased the development of gastric cancer. Further studies to investigate the role of H pylori eradication in participants with precancerous lesions are warranted.