IR@PKUHSC  > 北京大学临床肿瘤学院
学科主题临床医学
Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions
You, Wei-cheng; Brown, Linda M.; Zhang, Lian; Li, Ji-you; Jin, Mao-lin; Chang, Yun-Shen; Ma, Jun-ling; Pan, Kai-feng; Liu, Wei-dong; Hu, Yuanreng; Crystal-Mansour, Susan; Pee, David; Blot, William J.; Fraumeni, Joseph F., Jr.; Xu, Guang-wei; Gail, Mitchell H.
刊名JOURNAL OF THE NATIONAL CANCER INSTITUTE
2006-07-19
DOI10.1093/jnci/djj264
98期:14页:974-983
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Oncology
研究领域[WOS]Oncology
关键词[WOS]HELICOBACTER-PYLORI ERADICATION ; INTESTINAL METAPLASIA ; ATROPHIC GASTRITIS ; HIGH-RISK ; STOMACH-CANCER ; ANTIOXIDANT SUPPLEMENTS ; SERUM MICRONUTRIENTS ; BETA-CAROTENE ; LUNG-CANCER ; INFECTION
英文摘要

Background: Randomized trials have yielded mixed results on the effects of treatment for Helicobacter pylori and little information on the effects of vitamins or garlic supplements on precancerous gastric lesions. We conducted a randomized trial to test the effects of one-time H. pylori treatment and long-term vitamin or garlic supplements in reducing the prevalence of advanced precancerous gastric lesions. Methods: Most of the adults aged 35-64 years in 13 randomly selected villages in Linqu County, Shandong Province, China, were identified and given baseline endoscopies in 1994. In 1995, 3365 eligible subjects were randomly assigned in a factorial design to three interventions or placebos: amoxicillin and omeprazole for 2 weeks in 1995 (H. pylori treatment); vitamin C, vitamin E, and selenium for 7.3 years (vitamin supplement); and aged garlic extract and steam-distilled garlic oil for 7.3 years (garlic supplement). Subjects underwent endoscopies with biopsies in 1999 and 2003, and the prevalence of precancerous gastric lesions was determined by histopathologic examination of seven standard biopsy sites. The 3365 eligible randomized subjects represented 93.5% of those with baseline endoscopy and included all baseline histologic categories except gastric cancer. Only 0.18% had normal gastric mucosa. Logistic regression was used to estimate the intervention effects on the odds of advanced precancerous gastric lesions, and t-tests were used to assess effects on histologic severity. All statistical tests were two-sided. Results: H. pylori treatment resulted in statistically significant decreases in the combined prevalence of severe chronic atrophic gastritis, intestinal metaplasia, dysplasia, or gastric cancer in 1999 (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.62 to 0.95) and in 2003 (OR = 0.60; 95% Cl = 0.47 to 0.75), and had favorable effects on the average histopathologic severity and on progression and regression of precancerous gastric lesions in 2003. H. pylori treatment did not reduce the combined prevalence of dysplasia or gastric cancer. However, fewer subjects receiving H. pylori treatment (19/1130; 1.7%) than receiving placebo (27/1128; 2.4%) developed gastric cancer (adjusted P=.14). No statistically significant favorable effects were seen for garlic or vitamin supplements. Conclusion: H. pylori treatment reduces the prevalence of precancerous gastric lesions and may reduce gastric cancer incidence, but further data are needed to prove the latter point. Long-term vitamin or garlic supplementation had no beneficial effects on the prevalence of precancerous gastric lesions or on gastric cancer incidence.

语种英语
WOS记录号WOS:000239279000011
引用统计
被引频次:265[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/62363
专题北京大学临床肿瘤学院
作者单位1.NCI, Div Canc Epidemiol & Genet, Bethesda, MD 20892 USA
2.Peking Univ, Beijing Canc Hosp, Sch Oncol, Beijing, Peoples R China
3.Linqu Cty Publ Hlth Bur, Shandong, Peoples R China
4.Westat Corp, Rockville, MD USA
5.Informat Management Serv Inc, Rockville, MD USA
6.Int Epidemiol Inst Ltd, Rockville, MD USA
7.Vanderbilt Univ, Nashville, TN USA
推荐引用方式
GB/T 7714
You, Wei-cheng,Brown, Linda M.,Zhang, Lian,et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions[J]. JOURNAL OF THE NATIONAL CANCER INSTITUTE,2006,98(14):974-983.
APA You, Wei-cheng.,Brown, Linda M..,Zhang, Lian.,Li, Ji-you.,Jin, Mao-lin.,...&Gail, Mitchell H..(2006).Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions.JOURNAL OF THE NATIONAL CANCER INSTITUTE,98(14),974-983.
MLA You, Wei-cheng,et al."Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions".JOURNAL OF THE NATIONAL CANCER INSTITUTE 98.14(2006):974-983.
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