Secretion of blood group substances in duodenal, gastric and stomal ulcer, gastric carcinoma, and diabetes mellitus.

The ABO blood group and ABH secretor status have been determined for 368 patients with a duodenal ulcer, 202 patients with a gastric ulcer, 83 patients with a stomal ulcer, 105 patients with gastric cancer, 102 patients with diabetes mellitus, and a control group of 610 subjects consisting of healthy persons and of patients with other conditions attending the same hospital. The results have been analysed in conjunction with those reported in two other large series. For duodenal ulcer the results show that the relative incidence among non-secretors compared with secretors is 1.80 to 1, with 95% confidence limits of 1.55 to 1 and 2.03 to 1. For gastric ulcer the relative incidence is 1.42 to 1, with 95% confidence limits of 1.16 to 1 and 1.74 to 1. Comparison of the results for the two types of peptic ulcer shows that they are significantly different from one another. For both types of ulcer, the estimated risk among non-secretors was similar for blood group O and for the other blood groups and the results suggest that the specific risks associated with blood group O and with non-secretion multiply one another. It is concluded that the mechanisms by which blood group O and non-secretion affect the risk of developing a gastric or duodenal ulcer are related to one another; but that they do not depend on the presence of the blood group substances in the secretions. The proportion of non-secretors among patients with a stomal ulcer (49%) was higher than among patients with a duodenal ulcer (37%) and the order of the relationship between non-secretion and the three types of peptic ulcer (stomal, duodenal, and gastric) was the same as that for blood group O. Other data suggest that there may be a slight increase in the risk of gastric cancer among non-secretors, but that the occurrence of diabetes mellitus is independent of ABH secretion.