<I>Helicobacter pylori</I>と胃癌

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  • <I>Helicobacter pylori</I> and Gastric cancer

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Helicobacter pylori (H. pylori) has been classified as a group 1 (definite) carcinogen for gastric cancer on the basis of epidemiological evidence by the International Agency of Research on Cancer (IARC), a part of the World Health Organization (WHO) in 1994. Recent years, the relationship between H. pylori infection and gastric cancer has been proved not only in epidemiology but also in an animal experiments with Mongolian gerbils and prospective clinical studies. Most gastric cancers develop from a background of H. pylori-infected gastric mucosa involving atrophic gastritis and intestinal metaplasia. A clinical study conducted by the Japan Gast Study Group (JGSG) showed that the strategy of H. pylori eradication for patients who had endoscopic mucosal resection for early gastric cancer led to a reduction in the incidence of metachronous gastric cancers by approximately one-third. Therefore, the Japanese Society for Helicobacter Research has published a guideline recommending that H. pylori infection should be treated by eradication therapy. The Japanese Public Insulance Progam covers H. pylori eradication therapy for four diseases of gastroduodenal ulcers, gastric MALT lymphoma, idiopathic thrombocytopenic purpura (ITP) and the stomach after endoscopic resection of early gastric cancer. We must change the strategy for eliminating gastric cancer consist of H. pylori eradication as the primary prevention strategy and surveillance of gastric cancer using endoscopy as the secondary prevention strategy in Japan.

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