: -

...22 31 2017

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:

Hp

Hp

OConnor A, et al. Nat Rev Gastroenterol Hepatol 2017 (in press)

Peptic ulcer, gastric cancer, MALT lymphoma, coronary artery disease, cerebrovascular diseases, hypertension, Raynaud, migraine, hematologic diseases, chronic urticaria, liver diseases, autoimmune disorders-glaucoma (ocular Alzheimers)- neurodegenerative diseases, GERD-Barretts, esophageal adeno-ca, colon ca or other extraintestinal neoplasia

Sleisenger & Fordtrans 2010, Helicobacter 2012, World J Gastrointest Pathophysiol 2014

Hp

Ca Correa

CaFerlay J. et al. GLOBOCAN 2012

5 , 3 Ca ()10% Hp 25% CaHp (+) 3-6 x CaIARC (1994): Hp, Hp , Ca 2050,

Ca

The Eurogast Study Group. Gut 1993;34:1672-6.Yeh JM, et al. Cancer Causes Control 2009;20:2021-9.

Rokkas T, et al. Ann Gastroenterol 201726 10 RCTs52363

Hp

Wilson Jungner Wilson JM & Jungner G. WHO 1968

: 90%, : 95-100%

Hp IgG:

(PG1 PG1/PG2): / -

UBT: 96%, 93% ( PPI)

: 97%, 94% ( PPI)

Hp : 6-15 ()

Ca Hp :

( ) PPI ( )

()

Hp

Ca (): Ca: - , (US$83.000 Ca) Hp 50 US$25.000 - : US$50.000 UBT

CaOConnor A, et al. Nat Rev Gastroenterol Hepatol 2017 (in press)

/ Hp: 2.324 Hp 40-49 , Hp 2 (RR 0,84, 95%CI 0,73-0,97, P=0,015) (Leeds HELP study), placebo 13 4 (P=0,04)10 , Hp / /

/ Moayyedi P, et al. Lancet 2000;355:1665-9.Ford AC, et al. Gastroenterology 2005;129:1910-7.

Bristol Helicobacter project ( ): 10.537 20-59 UBT 1.636 Hp (+) (P=0,05) (P=0,02) 2 / 2 , Hp 7

/ Lane JA, et al. BMJ 2006;332:199-202.Harvey RF, et al. Aliment Pharmacol Ther 2010;32:394-400.

>?

In vitro

Hp

(C 0.136 mg/mL) (MBC 0.202 mg/mL)

total mastic extract without polymer (TMEWP)Paraschos S, et al. Antimicrob Agents Chemother 2007;51:551-559

TMEWP :

( 30 ) Hp

In vivo Paraschos S, et al. Antimicrob Agents Chemother 2007;51:551-559 TMEWP Hp ,

52 Hp : Hp in vivo

Hp ?

Dabos KJ, et al. Phytomedicine 2010;17:296-299

Hp, :

Ca ( ) ( , )

Hp: Ca

:

Take-home messages (1)

/ Hp :

Wilson Jungner cost-effective Ca -

Hp : PG

Hp

Take-home messages (2)

:

Hp >180.000 Hp Ca 2018

?

Pan KF, et al. Gut 2016;65:9-18.

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