Anti-Helicobacter pylori antibody status is associated with cancer mortality: A longitudinal analysis from the Japanese DAIKO prospective cohort study

Abstract

Paradoxically, patients with advanced stomach cancer who are Helicobacter pylori-positive (HP+) have a higher survival rate than those who are HP-. This finding suggests that HP infection has beneficial effects for cancer treatment. The present study examines whether HP+ individuals have a lower likelihood of death from cancer than those who are HP-. Prospective cohort data (n = 4,982 subjects enrolled in the DAIKO study between 2008–2010) were used to assess whether anti-HP antibody status was associated with cancer incidence. The median age in the primary registry was 53 years-old (range 35–69 years-old). Over the 8-year observation period there were 234 (4.7%) cancer cases in the cohort and 88 (1.8%) all-cause deaths. Urine anti-HP antibody data was available for all but one participant (n = 4,981; 99.98%). The number of HP+ and HP- individuals was 1,825 (37%) and 3,156 (63%), respectively. Anti-HP antibody distribution per birth year revealed that earlier birth year was associated with higher HP+ rates. With a birth year-matched cohort (n = 3,376), all-cancer incidence was significantly higher in HP+ individuals than those who were HP- (p = 0.00328), whereas there was no significant difference in the cancer death rate between HP+ and HP- individuals (p = 0.888). Cox regression analysis for prognostic factors revealed that the hazards ratio of HP+ was 1.59-fold (95%CI 1.17–2.26) higher than HP- in all-cancer incidence. Potential systemic effects of HP+ status may contribute to reduced likelihood of death for patients after an initial diagnosis of cancer.

How readable and quality are online patient education materials about Helicobacter pylori?: Assessment of the readability, quality and reliability

“…In the Cox regression analysis for prognostic factors performed in the study, it was stated that the hazard ratio of H pylori antibody-positive individuals was 1.59 times (95% CI 1.17-2.26) higher than that of H pylori antibody-negative individuals in all cancer incidences. [4] The prevalence of Helicobacter varies regionally and is reported to range between 10% and 90% in different studies. [5] These data highlight that H pylori infection is an important public health problem.…”

“…In the Cox regression analysis for prognostic factors performed in the study, it was stated that the hazard ratio of H pylori antibody-positive individuals was 1.59 times (95% CI 1.17–2.26) higher than that of H pylori antibody-negative individuals in all cancer incidences. [ 4 ]…”

Dynamic phospho-proteogenomic analysis of gastric cancer cells suggests host immunity provides survival benefit

“…These observations indicate that host could contribute to relapse after S-1 adjuvant chemotherapy in addition to tumor cell-intrinsic 5FU-resistance or immunosuppression mechanisms (i.e., activation of PAK-MEK1 pathways or PD-L1 expression). In line with this scenario, H. pylori infection, which can recruit T lymphocytes and macrophages to gastric mucosa 44 , might confer a potential survival benefit in patients with advanced GC even after gastrectomy 45 . However, despite a strong correlation with inflammation scores for gastric mucosa based on the Sydney System 46 , the presence of H. pylori does not seem to be directly related to TLC ( Fig.…”

“…In line with this scenario, H. pylori infection, which can recruit T lymphocytes and macrophages to gastric mucosa 44 , might confer a potential survival benefit in patients with advanced GC even after gastrectomy 45 . However, despite a strong correlation with inflammation scores for gastric mucosa based on the Sydney System 46 , the presence of H. pylori does not seem to be directly related to TLC (Fig.…”