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© 1998 Oxford University Press

research-article

Helicobacter pylori infection, garlic intake and precancerous lesions in a Chinese population at low risk of gastric cancer

Wei-cheng Youa,b,, Lian Zhangb, Mitchell H Gaila, Jun-ling Mac, Yun-sheng Changc, William J Blotd, Ji-you Lib, Cai-lin Zhaoe, Wei-dong Liuf, Hui-qing Lig, Yuan-reng Huh, Juan Carlos Bravoi, Pelayo Correai, Guang-wei Xua and Joseph F Fraumeni, Jra

aNational Cancer Institute Bethesda, MD 20892, USA
bBeijing Institute for Cancer Research and School of Oncology, Beijing Medical University Beijing, China 100034
cWeifang Blood Center Welfang, Shandong, China 261041
dInternational Epidemiology Institute, Ltd. Rockville, MD 20850, USA
eCangshan Public Health Bureau Shandong, China 277700
fLinqu Public Health Bureau Linqu, Shandong, China 262600
gShandong Academy of Medical Sciences Jinan, Shandong, China 250000
hWestat Inc. Rockville, MD 20850, USA
iLouisiana State University Medical Center New Orleans, LA 70112, USA

Reprint requests to: Wei-cheng You, National Cancer Institute, EPN Room 431, Bethesda, MD 20892, USA

BACKGROUND: Cangshan County of Shandong Province has one of the lowest rates of gastric cancer (GC) in China. While intestinal metaplasia (IM) and dysplasia (DYS) are less conimon in Cangshan than in areas of Shandong at high risk of GC, these precursor lesions nevertheless affect about 20% of adults age ≥55.

SUBJECTS AND SETTING: In order to evaluate determinants of IM and DYS in Cangshan County, a low risk area of GC a survey was conducted among 214 adults who participated in a gastroscopic saeening survey in Cangshan County in 1994.

METHODS: A dietary interview and measurement of serum Helicobacter pylori antibodies were performed.

RESULTS: The prevalence of H. pylori was lowest (19%) among those with normal gastric mucosa, rising steadily to 35% for superficial gastritis (SG), 56% for chronic atrophic gastritis (CAG), 80% for TM, and 100% for DYS. The prevalence odds of precancerous lesions were compared with the odds of normal histology or SG. The odds ratio (OR) or CAG associated with H. pylori positivity was 4.2 (95% confidence interval [CI] : 1.7–10.0), while the OR of IM/DYS associated with H. pylori positivity was 31.5 (95% CI: 5.2–187). After adjusting for H. pylori infection, drinking alcohol was a risk factor for CAG (OR = 3.2, 95% CT: 1.1–9.2) and IM/DYS (OR = 7.8, 95% CI: 1.3–47.7). On the other hand, consumption of garlic showed non-significant protective effects and an inverse association with H. pylori infection.

CONCLUSIONS: The findings of this study suggest that infection with H. pylori is a risk factor and garlic may be protective, in the development and progression of advanced precancerous gastric lesions in an area of China at relatively low risk of GC.

Keywords Precancerous gastric lesions, high and low risk, Helicobacter pylori, alcohol, garlic

Accepted 2 June 1998


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