幽门螺杆菌根除的卫生经济学考量
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摘要
胃癌是人类肿瘤疾病中与细菌感染直接相关的疾病之一,幽门螺杆菌(Helicobacter pylori,Hp)作为胃癌诱因病原体在人群中的携带率高达50%,Hp的根除指征也在不断进展,但是对于感染人群,尤其针对无症状的感染人群是否需进行根除治疗仍存有争议。文章根据中国卫生医疗现状,从卫生经济学角度出发,探讨Hp根除与胃癌防治的成本效益,为今后制定Hp感染人群的胃癌防治策略提供借鉴。
Gastric cancer is the one of human tumor disease that is directly related to bacterial infection disease. Helicobacter pylori(Hp)is a cancer-causing pathogen, whose prevalence rate in the population is as high as 50%. The indications for Hp eradication have been developong; however, for infected people, especially for the asymptomatic infection group, it remains controversial whether to perform the eradication therapy. This review describes the cost-effectiveness of eradicating Hp and the prevention and treatment of gastric cancer,based on the current situation of health care in China and from the perspective of health economics, so as to provide some ideas for the prevention and treatment of gastric cancer with domestic Hp infected people.
Gastric cancer is the one of human tumor disease that is directly related to bacterial infection disease. Helicobacter pylori(Hp)is a cancer-causing pathogen, whose prevalence rate in the population is as high as 50%. The indications for Hp eradication have been developong; however, for infected people, especially for the asymptomatic infection group, it remains controversial whether to perform the eradication therapy. This review describes the cost-effectiveness of eradicating Hp and the prevention and treatment of gastric cancer,based on the current situation of health care in China and from the perspective of health economics, so as to provide some ideas for the prevention and treatment of gastric cancer with domestic Hp infected people.
引文
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[3]姚芳,石春雷,刘成成,等.中国1996-2015年胃癌经济负担研究的系统评价[J].中华预防医学杂志,2017,51(8):756-762.
[4]Rugge M,Genta R M,Di Mario F,et al.Gastric cancer as preventable disease[J].Clin Gastroenterol Hepatol,2017,15(12):1833-1843.
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[8]Ford AC,Forman D,Hunt RH,et al.Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals:systematic review and meta-analysis of randomised controlled trials[J].BMJ,2014,348:g3174.
[9]Wong BC,Lam SK,Wong WM,et al.Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China:a randomized controlled trial[J].JAMA,2004,291(2):187-194.
[10]Fuccio L,Zagari RM,Minardi ME,et al.Systematic rev iew:Helicobacter pylori eradication for the prevention of gastric cancer[J]Aliment Pharmacol Ther,2007,25(2):133-141.
[11]余明,王博,张亚飞,等.癌前病变及胃癌与幽门螺杆菌感染的关系探讨[J].陕西医学杂志,2018,47(11):464-466.
[12]Correa P,Fontham ET,Bravo JC,et al.Chemoprevention of gastric dysplasia:randomized trial of antioxidant supplements and antihelicobacter pylori therapy[J].J Natl Cancer Inst,2000,92(23):1881-1888.
[13]You WC,Brown LM,Zhang L,et al.Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions[J].J Natl Cancer Inst,2006,98(14):974-983.
[14]Leung WK,Lin SR,Ching JY,et al.Factors predicting progression of gastric intestinal metaplasia:results of a randomised trial on Helicobacter pylori eradication[J].Gut,2004,53(9):1244-1249.
[15]Seo JY,Lee DH,Cho Y,et al.Eradication of Helicobacter pylori reduces metachronous gastric cancer after endoscopic resection of early gastric cancer[J].Hepatogastroenterology,2013,60(124):776-780.
[16]Sugano K,Tack J,Kuipers JE,et al.Kyoto global consensus report on Helicobacter pylori gastritis[J].Gut,2015,64(9):1353-1367.
[17]JAMA.NIH Consensus Conference.Helicobacter pylori in peptic ulcer disease.NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease[J].JAMA,1994,272(1):65-69.
[18]Warren JR.Helicobacter:The ease and difficulty of a new discovery(nobel lecture)[J].Chemmedchem,2010,37(36):177-184.
[19]Nagy P,Johansson S,Molloy-Bland M.Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA[J].Gut Pathog,2016,8:8.
[20]Ford AC,Michelle Q,Paul M,et al.Helicobacter pylori“test and treat”or endoscopy for managing dyspepsia:an individual patient data metaanalysis[J].Gastroenterology,2005,128(7):1838-1844.
[21]刘文忠.《幽门螺杆菌感染的处理:MaastrichtⅤ/Florence共识报告》解读[J].胃肠病学,2016,21(10):577-584.
[22]Lee YC,Lin JT.Screening and treating Helicobacter pylori infection for gastric cancer prevention on the population level[J].J Gastroenterol Hepatol,2017,32(6):1160-1169.
[23]O’connor A,O’morain CA,Ford AC.Population screening and treatment of Helicobacter pylori infection[J].Nat Rev Gastroenterol Hepatol,2017,14(4):230-240.
[24]张振忠,陈增辉,李敬伟.2012年版《全国医疗服务价格项目规范》修订原则及思路[J].中国卫生经济,2013,32(2):5-7.
[25]林青,林静.3种三联法治疗幽门螺旋杆菌感染的药物经济学分析[J].国际医药卫生导报,2003,9(18):28-29.
[26]Igakutsushinsha.Quick manual for reimbursement[Z],2015.
[27]Omata F,Shimbo T,Ohde S,et al.Cost-effectiveness analysis of Helicobacter pylori diagnostic methods in patients with atrophic gastritis[J].Gastroenterol Res Pract,2017,2017:2453-2454.
[28]潘光荣.C14呼气试验在消化性溃疡诊疗中的成本-效果分析[J].临床医学,2016,36(9):68-69.
[29]王月蓉,施亚玲.中西医结合治疗上消化道溃疡出血50例[J]中国中医急症,2012,21(9):1479-1479.
[30]Parsonnet J,Harris RA,Hack HM,et al.Modelling cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer:a mandate for clinical trials[J].Lancet,1996,348(9021):150.
[31]Harris RA,Owens DK,Witherell H,et al.Helicobacter pylori and gastric cancer:what are the benefits of screening only for the CagAphenotype of H.pylori?[J].Helicobacter,2010,4(2):69-76.
[32]Yeh JM,Kuntz KM,Ezzati M,et al.Development of an empirically calibrated model of gastric cancer in two high-risk countries[J].Cancer Epidemiol Biomarkers Prev,2008,17(5):1179.
[33]Yeh JM,Kuntz KM,Majid E,et al.Exploring the cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer in China in anticipation of clinical trial results[J].Int J Cancer J Int Du Cancer,2010,124(1):157-166.
[34]刘文忠,谢勇,成虹,等.第四次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2012,51(10):832-837.
[35]Malfertheiner P,Megraud F,O’morain CA,et al.Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report[J].Gut,2017,66(1):6-30.
[36]王倩,金丕焕,林果为,等.筛查幽门螺杆菌感染预防胃癌的费用效果分析[J].世界华人消化杂志,2000,8(3):262-265.
[37]Wang B,Lv ZF,Wang YH,et al.Standard triple therapy for Helicobacter pylori infection in China:A meta-analysis[J].World JGastroenterology,2014,20(40):14973-14985.
[38]Kikuchi S,Dore MP.Epidemiology of Helicobacter pylori Infection[J]Helicobacter,2005,10(Supplement s1):1-4.
[39]Abu-Mahfouz MZ,Prasad VM,Santogade P,et al.Helicobacter pylori recurrence after successful eradication:5-year follow-up in the United States[J].American J Gastroenterology,1997,92(11):2025.
[40]Morgan DR,Javier T,Rachael S,et al.Risk of recurrent Helicobacter pylori infection 1 year after initial eradication therapy in 7 Latin American communities[J].JAMA,2013,309(6):578-586.
[41]Zhang YX,Zhou LY,Song ZQ,et al.Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing:a prospective serial study[J].World JGastroenterology,2015,21(9):2786.
[42]Chuan X,Nong-Hua L.Review:clinical management of Helicobacter pylori infection in China[J].Helicobacter,2015,20(1):1-10.
[43]Peter M,Francis M,O’morain CA,et al.Management of Helicobacter pylori infection--the Maastricht IV/Florence Consensus Report[J]2012.
[44]White E,Urban N,Taylor V.Mammography utilization,public health impact,and cost-effectiveness in the United States[J].Annu Rev Public Health,1993,14(14):605-633.
[45]Russell LB,Gold MR,Siegel JE,et al.The Role of Cost-effectiveness Analysis in Health and Medicine[J].JAMA,1996,276(14):1172-1177.
[46]Siegel JE,Weinstein MC,Russell LB,et al.Recommendations for reporting cost-effectiveness analyses.Panel on Cost-Effectiveness in Health and Medicine[J].JAMA,1996,276(16):1339-1341.
[47]Gold MR,Seigel JE,Russell LB,et al.Cost-effectiveness in health and medicine[J].BMJ,1996,315(4):1290-1291.
[48]Sonnenberg A,DelcòF.Cost-effectiveness of a single colonoscopy in screening for colorectal cancer[J].Archives of Internal Medicine,2002162(2):163-168.
[49]Herrero R,Park JY,Forman D.The fight against gastric cancer-the IARC Working Group report[J].Best Pract Res Clin Gastroenterol2014,28(6):1107-1114.
[50]Samsonov AGV,Andreev Dn,Iurenev Gl,et al.Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases[J].Ter Arkh,2014,86(8):56-61.
[51]Kajihara YST,Mizuki I.Analysis of the cost-effectiveness of using vonoprazan-amoxicillin-clarithromycin triple therapy for first-line Helicobacter pylori eradication.[J].Scand J Gastroenterol,201752(2):238-241.
[52]王倩,林果为,金丕焕,等.筛查幽门螺杆菌预防胃癌的Markov模型卫生经济学评价[J].中华流行病学杂志,200324(2):135-139.
[53]Kowada A.Cost-effectiveness of Helicobacter pylori screening followed by eradication treatment for employees in Japan[J].Epidemiol Infect2018,146(14):1834-1840.
[54]Lansdorp-Vogelaar I,Sharp L.Cost-effectiveness of screening and treating Helicobacter pylori for gastric cancer prevention[J].Best Pract Res Clin Gastroenterol,2013,27(6):933-947.
[2]Chen W,Zheng R,Baade P D,et al.Cancer statistics in China,2015[J]CA Cancer J Clin,2016,66(2):115-132.
[3]姚芳,石春雷,刘成成,等.中国1996-2015年胃癌经济负担研究的系统评价[J].中华预防医学杂志,2017,51(8):756-762.
[4]Rugge M,Genta R M,Di Mario F,et al.Gastric cancer as preventable disease[J].Clin Gastroenterol Hepatol,2017,15(12):1833-1843.
[5]Correa P.Is gastric cancer preventable?[J].Gut,2004,53(9):1217-1219.
[6]Listed N.Schistosomes,liver flukes and Helicobacter pylori.IARCWorking Group on the Evaluation of Carcinogenic Risks to Humans Lyon,7-14 June 1994[J].Iarc Monographs on the Evaluation of Carcinogenic Risks to Humans,1994,61:1.
[7]Donald Maxwell P.The global health burden of infection-associated cancers in the year 2002[J].International J Cancer,2010,118(12):3030-3044.
[8]Ford AC,Forman D,Hunt RH,et al.Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals:systematic review and meta-analysis of randomised controlled trials[J].BMJ,2014,348:g3174.
[9]Wong BC,Lam SK,Wong WM,et al.Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China:a randomized controlled trial[J].JAMA,2004,291(2):187-194.
[10]Fuccio L,Zagari RM,Minardi ME,et al.Systematic rev iew:Helicobacter pylori eradication for the prevention of gastric cancer[J]Aliment Pharmacol Ther,2007,25(2):133-141.
[11]余明,王博,张亚飞,等.癌前病变及胃癌与幽门螺杆菌感染的关系探讨[J].陕西医学杂志,2018,47(11):464-466.
[12]Correa P,Fontham ET,Bravo JC,et al.Chemoprevention of gastric dysplasia:randomized trial of antioxidant supplements and antihelicobacter pylori therapy[J].J Natl Cancer Inst,2000,92(23):1881-1888.
[13]You WC,Brown LM,Zhang L,et al.Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions[J].J Natl Cancer Inst,2006,98(14):974-983.
[14]Leung WK,Lin SR,Ching JY,et al.Factors predicting progression of gastric intestinal metaplasia:results of a randomised trial on Helicobacter pylori eradication[J].Gut,2004,53(9):1244-1249.
[15]Seo JY,Lee DH,Cho Y,et al.Eradication of Helicobacter pylori reduces metachronous gastric cancer after endoscopic resection of early gastric cancer[J].Hepatogastroenterology,2013,60(124):776-780.
[16]Sugano K,Tack J,Kuipers JE,et al.Kyoto global consensus report on Helicobacter pylori gastritis[J].Gut,2015,64(9):1353-1367.
[17]JAMA.NIH Consensus Conference.Helicobacter pylori in peptic ulcer disease.NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease[J].JAMA,1994,272(1):65-69.
[18]Warren JR.Helicobacter:The ease and difficulty of a new discovery(nobel lecture)[J].Chemmedchem,2010,37(36):177-184.
[19]Nagy P,Johansson S,Molloy-Bland M.Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA[J].Gut Pathog,2016,8:8.
[20]Ford AC,Michelle Q,Paul M,et al.Helicobacter pylori“test and treat”or endoscopy for managing dyspepsia:an individual patient data metaanalysis[J].Gastroenterology,2005,128(7):1838-1844.
[21]刘文忠.《幽门螺杆菌感染的处理:MaastrichtⅤ/Florence共识报告》解读[J].胃肠病学,2016,21(10):577-584.
[22]Lee YC,Lin JT.Screening and treating Helicobacter pylori infection for gastric cancer prevention on the population level[J].J Gastroenterol Hepatol,2017,32(6):1160-1169.
[23]O’connor A,O’morain CA,Ford AC.Population screening and treatment of Helicobacter pylori infection[J].Nat Rev Gastroenterol Hepatol,2017,14(4):230-240.
[24]张振忠,陈增辉,李敬伟.2012年版《全国医疗服务价格项目规范》修订原则及思路[J].中国卫生经济,2013,32(2):5-7.
[25]林青,林静.3种三联法治疗幽门螺旋杆菌感染的药物经济学分析[J].国际医药卫生导报,2003,9(18):28-29.
[26]Igakutsushinsha.Quick manual for reimbursement[Z],2015.
[27]Omata F,Shimbo T,Ohde S,et al.Cost-effectiveness analysis of Helicobacter pylori diagnostic methods in patients with atrophic gastritis[J].Gastroenterol Res Pract,2017,2017:2453-2454.
[28]潘光荣.C14呼气试验在消化性溃疡诊疗中的成本-效果分析[J].临床医学,2016,36(9):68-69.
[29]王月蓉,施亚玲.中西医结合治疗上消化道溃疡出血50例[J]中国中医急症,2012,21(9):1479-1479.
[30]Parsonnet J,Harris RA,Hack HM,et al.Modelling cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer:a mandate for clinical trials[J].Lancet,1996,348(9021):150.
[31]Harris RA,Owens DK,Witherell H,et al.Helicobacter pylori and gastric cancer:what are the benefits of screening only for the CagAphenotype of H.pylori?[J].Helicobacter,2010,4(2):69-76.
[32]Yeh JM,Kuntz KM,Ezzati M,et al.Development of an empirically calibrated model of gastric cancer in two high-risk countries[J].Cancer Epidemiol Biomarkers Prev,2008,17(5):1179.
[33]Yeh JM,Kuntz KM,Majid E,et al.Exploring the cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer in China in anticipation of clinical trial results[J].Int J Cancer J Int Du Cancer,2010,124(1):157-166.
[34]刘文忠,谢勇,成虹,等.第四次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2012,51(10):832-837.
[35]Malfertheiner P,Megraud F,O’morain CA,et al.Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report[J].Gut,2017,66(1):6-30.
[36]王倩,金丕焕,林果为,等.筛查幽门螺杆菌感染预防胃癌的费用效果分析[J].世界华人消化杂志,2000,8(3):262-265.
[37]Wang B,Lv ZF,Wang YH,et al.Standard triple therapy for Helicobacter pylori infection in China:A meta-analysis[J].World JGastroenterology,2014,20(40):14973-14985.
[38]Kikuchi S,Dore MP.Epidemiology of Helicobacter pylori Infection[J]Helicobacter,2005,10(Supplement s1):1-4.
[39]Abu-Mahfouz MZ,Prasad VM,Santogade P,et al.Helicobacter pylori recurrence after successful eradication:5-year follow-up in the United States[J].American J Gastroenterology,1997,92(11):2025.
[40]Morgan DR,Javier T,Rachael S,et al.Risk of recurrent Helicobacter pylori infection 1 year after initial eradication therapy in 7 Latin American communities[J].JAMA,2013,309(6):578-586.
[41]Zhang YX,Zhou LY,Song ZQ,et al.Primary antibiotic resistance of Helicobacter pylori strains isolated from patients with dyspeptic symptoms in Beijing:a prospective serial study[J].World JGastroenterology,2015,21(9):2786.
[42]Chuan X,Nong-Hua L.Review:clinical management of Helicobacter pylori infection in China[J].Helicobacter,2015,20(1):1-10.
[43]Peter M,Francis M,O’morain CA,et al.Management of Helicobacter pylori infection--the Maastricht IV/Florence Consensus Report[J]2012.
[44]White E,Urban N,Taylor V.Mammography utilization,public health impact,and cost-effectiveness in the United States[J].Annu Rev Public Health,1993,14(14):605-633.
[45]Russell LB,Gold MR,Siegel JE,et al.The Role of Cost-effectiveness Analysis in Health and Medicine[J].JAMA,1996,276(14):1172-1177.
[46]Siegel JE,Weinstein MC,Russell LB,et al.Recommendations for reporting cost-effectiveness analyses.Panel on Cost-Effectiveness in Health and Medicine[J].JAMA,1996,276(16):1339-1341.
[47]Gold MR,Seigel JE,Russell LB,et al.Cost-effectiveness in health and medicine[J].BMJ,1996,315(4):1290-1291.
[48]Sonnenberg A,DelcòF.Cost-effectiveness of a single colonoscopy in screening for colorectal cancer[J].Archives of Internal Medicine,2002162(2):163-168.
[49]Herrero R,Park JY,Forman D.The fight against gastric cancer-the IARC Working Group report[J].Best Pract Res Clin Gastroenterol2014,28(6):1107-1114.
[50]Samsonov AGV,Andreev Dn,Iurenev Gl,et al.Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases[J].Ter Arkh,2014,86(8):56-61.
[51]Kajihara YST,Mizuki I.Analysis of the cost-effectiveness of using vonoprazan-amoxicillin-clarithromycin triple therapy for first-line Helicobacter pylori eradication.[J].Scand J Gastroenterol,201752(2):238-241.
[52]王倩,林果为,金丕焕,等.筛查幽门螺杆菌预防胃癌的Markov模型卫生经济学评价[J].中华流行病学杂志,200324(2):135-139.
[53]Kowada A.Cost-effectiveness of Helicobacter pylori screening followed by eradication treatment for employees in Japan[J].Epidemiol Infect2018,146(14):1834-1840.
[54]Lansdorp-Vogelaar I,Sharp L.Cost-effectiveness of screening and treating Helicobacter pylori for gastric cancer prevention[J].Best Pract Res Clin Gastroenterol,2013,27(6):933-947.