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目的：幽门螺杆菌（Ｈｐ）是慢性胃炎的主要致病因子，在消化性溃疡的发生中起重要作用。根据慢性胃炎→腺体萎缩→肠上皮化生→异型增生→胃癌发生学说，Ｈｐ在胃癌发生中的作用受到了人们重视。本研究目的是探讨Ｈｐ感染与胃癌发生的关系。方法：采用配对病例对照研究方法。自１９９４年１月～１９９５年１２月中山医院共进行胃镜检查１１０００例病人，经胃镜确诊为胃癌１３６例，组成病例组。性别相同，年龄相差在５岁范围内，相同或相近检查日期的胃炎病人作为对照组。Ｈｐ检测采用快速尿素酶法和病理染色相结合。Ｈｐ感染的诊断标准是：两种检测方法中任一阳性即定为阳性，两者均阴性定为阴性。统计方法采用Ｍａｎｔｅｌ－Ｈａｅｎｓｚｅｌ卡方检验。结果：总的胃癌检出率为１２４％（１３６／１１０００）。按照肿瘤生长部位，胃窦、胃体、贲门部所占比例分别为４６３％、３４６％、１５４％；按照肿瘤的病理类型，腺癌的比例最高（８８例，占６４７％）。Ｈｐ感染率在病例组（７４３％）明显高于对照组（５７４％，ＯＲ＝２３５，９５％ＣＩ１３３－４１５）。考虑到肿瘤发生部位及类型的影响，非贲门部肿瘤病人Ｈｐ感染率（８９／１１５，７７３％）明显高于对照组（?
Objective: Helicobacter pylori (Hp) is the main pathogenic factor of chronic gastritis and plays an important role in the occurrence of peptic ulcer. According to the theory of chronic gastritis→ gland atrophy→ intestinal epithelial metaplasia→ dysplasia→ gastric cancer, the role of Hp in the development of gastric cancer has received attention. The purpose of this study was to investigate the relationship between Hp infection and the occurrence of gastric cancer. Methods: A matched case-control study was used. From January 1994 to December 1995, 11,000 patients underwent gastroscopy at the Zhongshan Hospital, and 136 cases of gastric cancer were confirmed by endoscopy. Genders were the same, ages were within the 5-year range, and patients with gastritis of the same or similar examination date served as controls. Hp detection was combined with rapid urease method and pathological staining. The diagnostic criteria for Hp infection are: any of the two test methods is positive, and both are negative. The statistical method was Mantel-Haenszel chi-square test. Results: The overall detection rate of gastric cancer was 1. 24% (136/11000). According to the site of tumor growth, the proportions of gastric antrum, gastric body, and cardia were 46. 3%, 34.6%, and 15.4%, respectively; according to the pathological type of tumor, the proportion of adenocarcinoma was the highest (88 cases, accounting for 64%). 7%). The Hp infection rate was significantly higher in the case group (74. 3%) than in the control group (57.4%, OR=2.35%, 95%CI133-415). Considering the influence of tumor location and type, the rate of Hp infection in patients with non cardia cancer was significantly higher than that in the control group (89/115, 77. 3%).