文章：

幽门螺杆菌与胃肠道腺癌

Helicobacter pylori and gastrointestinal tract adenocarcinomas

原文发布日期：2002-01-01

DOI: 10.1038/nrc703

类型: Review Article

开放获取: 否

要点：

1. Gastric adenocarcinoma is the second leading cause of cancer-related deaths in the world, and has been associated with the presence of Helicobacter pylori in the stomach.
2. Gastric cancer involves a transition from normal mucosa to gastritis, which then leads eventually to adenocarcinoma. The ability of H. pylori to induce superficial gastritis indicates that it is involved in the initiation and promotion of gastric neoplasia. Many clinical and animal studies support this idea.
3. H. pylori populations are extremely diverse, due to point mutations, substitutions, insertions and/or deletions in their genomes. Cancer risk is believed to be related to H. pylori strain differences.
4. There are also a number of human polymorphisms associated with gastric cancer. Most of these occur within immune-response genes.
5. H. pylori have a number of direct effects on host epithelial tissues that could affect tumorigenesis, including induction of proliferation, the inflammatory response and apoptosis.
6. So, host and pathogen are likely to be linked in a dynamic equilibrium, in which the host responses to bacterial colonization affect the growth of certain bacterial strains, and strain phenotype affects the nature of the host response.
7. Remarkably, the presence of H. pylori reduces the risk of developing other types of cancer, such as oesophageal adenocarcinoma. The same biological effects of H. pylori that predispose people to gastric cancer are likely to protect them from oesophageal cancer.

要点翻译：

1. 胃腺癌是全球癌症相关死亡的第二大原因，且与胃内幽门螺杆菌的存在相关。
2. 胃癌的发生经历从正常黏膜到胃炎，最终进展为腺癌的演变过程。幽门螺杆菌诱发浅表性胃炎的能力表明，它参与了胃肿瘤发生的起始和促进阶段。众多临床及动物研究均支持这一观点。  
3. 幽门螺杆菌种群具有极高的多样性，源于其基因组中的点突变、碱基替换、插入和/或缺失。癌症风险被认为与幽门螺杆菌菌株差异相关。
4. 此外还存在多种与胃癌相关的人类基因多态性，其中多数发生在免疫应答基因内。  
5. 幽门螺杆菌对宿主上皮组织产生多种直接影响（包括诱导增殖、炎症反应和细胞凋亡），这些影响可能参与肿瘤发生。
6. 因此，宿主与病原体很可能处于动态平衡状态：宿主对细菌定植的应答会影响特定菌株的生长，而菌株表型又会影响宿主应答的性质。  
7. 值得注意的是，幽门螺杆菌的存在可降低其他类型癌症（如食管腺癌）的发病风险。那些使人群易患胃癌的幽门螺杆菌生物学效应，可能同时保护他们免受食管癌的侵害。

英文摘要：

Although gastric adenocarcinoma is associated with the presence of Helicobacter pyloriin the stomach, only a small fraction of colonized individuals develop this common malignancy. H. pyloristrain and host genotypes probably influence the risk of carcinogenesis by differentially affecting host inflammatory responses and epithelial-cell physiology. Understanding the host–microbial interactions that lead to neoplasia will improve cancer-targeted therapeutics and diagnostics, and provide mechanistic insights into other malignancies that arise within the context of microbially initiated inflammatory states.

摘要翻译： 

尽管胃腺癌与胃内幽门螺杆菌的存在相关，但在感染者中，仅有少数人会发展为这种常见恶性肿瘤。幽门螺杆菌菌株与宿主基因型可能通过差异调控宿主炎症反应及上皮细胞生理，进而影响致癌风险。阐明导致肿瘤发生的宿主—微生物相互作用，将有助于改进癌症靶向治疗与诊断，并为其他由微生物诱发炎症状态所驱动的恶性肿瘤提供机制性洞见。

原文链接：

Helicobacter pylori and gastrointestinal tract adenocarcinomas