Digestive Diseases and Sciences

, Volume 42, Issue 7, pp 1383–1387

Helicobacter pylori Infection and Gastric Cancer (A Nested Case-Control Study in a Rural Area of Japan)

  • Authors
  • Yoshiyuki Watanabe
  • John H. Kurata
  • Shigeto Mizuno
  • Masako Mukai
  • Hideto Inokuchi
  • Kazumasa Miki
  • Kotaro Ozasa
  • Keiichi Kawai

DOI: 10.1023/A:1018833819860

Cite this article as:
Watanabe, Y., Kurata, J.H., Mizuno, S. et al. Dig Dis Sci (1997) 42: 1383. doi:10.1023/A:1018833819860


We conducted a seroepidemiological nested case-control study to determine the association of gastriccancer with Helicobacter pylori infection and atrophicgastritis. A cohort of 2858 participants in an annual multiphasic health check-up werefollowed for eight years. Data for 45 gastric cancercases and 225 sex-, age-, and address-matched controlsubjects were analyzed. Helicobacter pylori infectionwas determined by IgG antibodies, and atrophicgastritis was diagnosed by both serum pepsinogen I level(≤70 ng/ml) and the pepsinogen I/II ratio (≤3.0).Univariate analysis showed that Helicobacter pylori and atrophic gastritis were significantlyassociated with gastric cancer. In a multivariateanalysis, atrophic gastritis was associated withsignificantly increased risk of cancer (odds ratio,3.38; 95% confidence interval, 1.54-7.42); however,Helicobacter pylori was not associated with cancer (oddsratio, 1.84; 95% confidence interval, 0.59-5.72). Theseresults suggest that Helicobacter pylori infection alone is not directly associated with gastriccarcinogenesis but has an indirect relation to gastriccancer through the development of atrophicgastritis.


Copyright information

© Plenum Publishing Corporation 1997