推荐意见2：推荐幽门螺杆菌感染阳性患者接受根除幽门螺杆菌治疗，以降低胃癌发病及相关死亡风险（强推荐，证据级别：中）。 幽门螺杆菌是一种可在胃中生存的微生物，中国人群个体感染率达40.6%，家庭感染率达71.2%［16］。幽门螺杆菌感染可引起慢性胃炎，导致胃溃疡和胃萎缩，严重者则发展为胃癌。研究表明，幽门螺杆菌感染是胃癌发生的明确诱因，感染者的胃癌发生风险约为非感染者的3倍［17］。国际癌症研究机构报告显示，约78%的胃癌发生与幽门螺杆菌感染有关［18］。 幽门螺杆菌可通过药物治疗清除，有效率可达75%~90%。根除幽门螺杆菌能够降低胃癌发生和相关死亡风险。综合分析截至2019年全球10项随机对照试验数据的结果［19］显示，根除幽门螺杆菌治疗能够使胃癌发生风险降低46%，使胃癌相关死亡风险降低39%（表3）。此外，对接受内镜治疗的早期胃癌进行根除治疗，能够使胃癌的复发风险降低51%。 参考文献（下滑查看）： [1]SungH, FerlayJ, SiegelRL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660. [2]ThriftAP, El-SeragHB. Burden of gastric cancer[J]. Clin Gastroenterol Hepatol, 2020, 18(3): 534-542. DOI: 10.1016/j.cgh.2019.07.045. [3]XiaC, DongX, LiH, et al. Cancer statistics in China and united states, 2022: profiles, trends, and determinants[J]. Chin Med J (Engl), 2022, 135(5): 584-590. DOI: 10.1097/CM9.0000000000002108. 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