ABSTRACT Background. It is known that the incidence and mortality rate of gastric cancer is high among Japanese and Chinese populations, but extremely low in Thai and Vietnamese populations. The aim of this study was to investigate the prevalence of Helicobacter pylori infection and the differences in the glandular atrophy and intestinal metaplasia scores in stomach specimens of Asian adult subjects of different races. Materials and Methods. Chinese, Thai, Vietnamese and Japanese patients were matched by age, gender and endoscopic diagnosis, in order to compare the differences in incidence of H. pylori ‐related peptic ulcer disease and the prevalence of H. pylori infection among four Asian populations (n = 700). Glandular atrophy scores and intestinal metaplasia scores were also compared among four Asian populations divided into H. pylori ‐positive cases (n = 120, 109, 145, 80, respectively) and H. pylori ‐negative cases (n = 55, 66, 30, 95, respectively). Results. Among peptic ulcers, gastric ulcer was more frequently seen in Japanese subjects than in the other Asian populations examined. On the other hand, duodenal ulcer was more frequently seen in other Asian populations than in Japanese subjects. The prevalence of H. pylori infection was similar in the Japanese (Tokyo) and Chinese (Beijing and Fuzhou) populations. It was higher in Thai (Chiang Mai) subjects compared with Japanese subjects. On the other hand, Vietnamese (Ho Chi Minh) subjects had significantly lower rates of H. pylori infection than Japanese subjects. The glandular atrophy and intestinal metaplasia scores in the stomach were significantly higher in the H. pylori ‐positive Japanese subjects than in H. pylori ‐positive subjects belonging to other Asian populations, except for the higher glandular atrophy scores in Chinese rather than Japanese subjects. On the other hand, there were no significant differences in the glandular atrophy and intestinal metaplasia scores in the angulus of the stomach among H. pylori ‐negative subjects belonging to the different Asian populations examined. Conclusions. Gastric ulcer was more common among Japanese subjects, while duodenal ulcer was more common among the other Asian populations examined. Japanese subjects with H. pylori infection showed more severe atrophic and metaplastic gastritis compared with that in other Asian subjects with H. pylori infection. These results may be related to the higher incidence of gastric cancer noted in Japanese subjects and the lower incidence of the cancer seen in Thai and Vietnamese patients.
Mutagenicity of cigarette smoke condensate (CSC) and the acidic, basic and neutral fractions of CSC was examined In the AL hybrid cell, a Chinese hamster ovary cell containing one human chromosome 11. Since the human chromosome 11 is not necessary for survival of the AL cells, mutations involving large deletions and chromosomal loss by non dysjunction are non-lethal events that are detectable by loss of human cell surface antigens (a1, a2 and a3) encoded by genes on chromosome up (a1 and a3) and llq (a2) through an antibody-complement lysis assay. Exposure of AL celic to CSC without exogenous metabolic activation caused a dosedependent cytotoxicity and mutagenicity. Mutagemcity also Increased with time of incubation up to 3 h with a maximum of 300 a1- mutants/105 survivors (250% above background; P < 0.0005) after incubation with 100 μg/ml CSC. Cytotoxicity and mutagenicity of CSC were inversely proportional to cell density. Fifty percent lethal doses for the acidic, basic and neutral fractions of CSC after 3 h of incubation were 30, 100 and 240 μg/ml respectively, and the acidic fraction at a concentration of 25 μg/ml induced 350 a1- mutants/105 survivors (230% above background; P < 0.0005); the basic and neutral fractions were less mutagenic. These results indicate that CSC and fractions of CSC can directly produce a spectrum of mutations, through both deletional and non-dysjunctlonal mechanisms of a kind known to lead to inactivation of tumor suppressor genes.
Non-simultaneous primary malignant tumors in five different organs were detected in a case of cancer family syndrome, and the patient's offspring were found to have colorectal cancers during follow-up. The first cancer in the patient was found in the transverse colon at the age of 47, and partial colectomy was carried out. The second and third were cancers of the cecum and gallbladder which were found concurrently at the age of 61, and ileocecal resection and cholecystectomy were carried out simultaneously. The fourth was cancer of the urinary bladder which was found at the age of 66, and partial cystectomy with interstitial irradiation using a radon seed in the residual urinary bladder was carried out. The fifth was cancer of the stomach at the age of 72, and subtotal gastrectomy was carried out. All of the resected specimens were demonstrated to be different carcinomas histologically. The father and 5 of the 7 siblings of this patient suffered from gastrointestinal or uterine cancers. Furthermore, two daughters of this patient were affected with cancer; the younger with cancer of the descending colon at the age of 47, and the elder with cancers of the transverse colon and rectum at the age of 54. Thus, familial clustering of cancer was shown. Genetic characteristics may have contributed to the development of multiple primary cancers in this family.
Monozygotic twins developed gastric cancers that were found almost simultaneously. A 47-year-old man complained of nausea and vomiting; an upper gastrointestinal series and endoscopy revealed advanced gastric cancer invading the serosa. Palliative subtotal gastrectomy was performed. In his asymptomatic twin a gastric polyp was detected during a screening examination, and this was observed for 2 years. After the former twin had undergone surgery, the latter twin was given a detailed endoscopic examination, and biopsy revealed gastric cancer limited to within the mucosa. Curative subtotal gastrectomy was performed. The noncancerous gastric mucosa of the former twin showed severe intestinal metaplasia, but that in the latter showed only spotty metaplasia. They had lived together for 40 years, but the former was a heavy smoker and drank alcohol, while the latter did not. These differences in taste might have contributed to the observed difference in intestinal metaplasia, which indicates chronic mucosal damage.
Japan and Thailand have high incidences of bile duct carcinoma and gallstones. The presence of Helicobacter bilis ( H. bilis ) detected by polymerase chain reaction (PCR) and 16S rRNA analysis in bile samples from Chileans with chronic cholecystitis was reported. The association between H. bilis in bile and biliary tract malignancies has not been investigated, and therefore the aim of this study is to determine whether malignant diseases of the biliary tract are associated with the presence of H. bilis in bile samples obtained from two high‐risk populations. Bile samples from 45 Japanese and 40 Thai patients were subjected to PCR analysis using H. bilis ‐specific primers, and six of the H. bilis amplicons were sequenced. Thirteen out of 15 (87%) Japanese and 11 out of 14 (79%) Thai patients with bile duct or gallbladder cancer tested positive for the presence of H. bilis in their bile. Eight out of 16 (50%) Japanese and 10 out of 26 (38%) Thai patients with gallstone and/or cholecystitis tested positive for H. bilis. Only 4 out of 14 (29%) subjects without biliary disease tested positive for H. bilis among the Japanese. Bile duct and gallbladder cancer showed significantly higher positive rates for H. bilis than did the non‐biliary diseases among the Japanese ( P <0.01) and the odds ratios for bile duct or gallbladder cancer with H. bilis in comparison with gallstone and/or cholecystitis were 6.50 (95%CI 1.09–38.63) in the Japanese and 5.86 (1.31–26.33) in the Thai patients. In conclusion, H. bilis infection in bile was associated with biliary tract and gallbladder cancers in two high risk populations, Japanese and Thai.
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