| 摘要: | 背景：胃癌是全球第三大致死癌，小腸化生是很重要的癌前病變，會增加6倍胃癌風險，而且沒有特殊症狀以利早期發現。
目的：欲探討在一般族群及胃癌家屬中，發生小腸化生的風險因子。
方法：從2007年至2013年在台中榮民總醫院，自健檢民眾及胃癌家屬中，建立一個以醫院為基礎的病例對照研究，並利用年齡性別以1:3的方式配對選取研究對象，使用條件式羅吉斯迴歸多變項分析以探討發生小腸化生的獨立風險因子。
結果：自研究中選取病例組208位、對照組624位，多變項分析中發現胃癌家族史（勝算比：2.02，95%信賴區間：1.25-3.28）、幽門螺旋桿菌感染（勝算比：1.54，95%信賴區間：1.09-2.16）、胃潰瘍（勝算比：1.63，95%信賴區間：1.10-2.41）、過去有胃潰瘍病史（勝算比：2.01，95%信賴區間：1.34-3.03）、糖尿病家族史（勝算比：1.81，95%信賴區間：1.09-3.01）是影響小腸化生發生的危險因子，而每天吃新鮮水果（勝算比：0.64，95%信賴區間：0.45-0.92）、高血壓（勝算比：0.48，95%信賴區間：0.29-0.80）則是保護因子。
結論：胃癌家族史、幽門螺旋桿菌感染、胃潰瘍、過去有胃潰瘍病史、糖尿病家族史與小腸化生的發生有正相關，而每天吃新鮮水果、高血壓則是反相關。
Background: Gastric cancer remains one of the leading causes of cancer mortality worldwide. Intestinal metaplasia, the key precancerous lesion of stomach, increases 6-times risk of gastric cancer and usually has no specific symptoms to detect early.
Aim: We aim to investigate the factors associated the development of intestinal metaplasia in the general population and relatives of gastric cancer.
Method: We conducted a hospital-based case-control study with age- and gender-matching between 2007 and 2013 at Taichung Veterans General Hospital. Conditional logistic regression was conducted to examine the independent factors associated with intestinal metaplasia.
Results: Between 2007 and 2013, we identified 208 subjects with IM and 624 age- and gender-matched controls. Multivariate analyses found family history of gastric cancer (OR: 2.02, 95% CI: 1.25-3.28), H. pylori infection (OR: 1.54, 95% CI: 1.09-2.16), gastric ulcer (OR: 1.63, 95% CI: 1.10-2.41), past history of gastric ulcer (OR: 2.01, 95% CI: 1.34-3.03), and family history of diabetes (OR: 1.81, 95%CI: 1.09-3.01) were independent risk factors for intestinal metaplasia development. Daily consumption of fruit and hypertension were found to be inversely related with intestinal metaplasia (OR: 0.64, 95% CI: 0.45-0.92; OR: 0.48, 95% CI: 0.29-0.80, respectively).
Conclusion: In conclusion, family history and H. pylori infection, gastric ulcer, past history of gastric ulcer, and family history of diabetes were independent risk factors for intentional metaplasia. Daily fruit intake and hypertension were protective factors. |
