Association ofHelicobacter pyloriinfection with esophageal adenocarcinoma and squamous cell carcinoma: a meta-analysis

Abstract

To evaluate the relationship of Helicobacter pylori and cytotoxin-associated gene A (CagA) positive strains with esophageal neoplasm, including esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), the authors conducted a meta-analysis using a predefined protocol. PubMed, Web of Science, China biology medical literature database, Wanfang, and China National Knowledge Infrastructure were searched for relevant articles from the first available year to April 8, 2013. The fixed or random effect pooled measure was selected based on heterogeneity among studies, which was evaluated using Q test and the I(2) of Higgins and Thompson. Metaregression was used to explore the sources of between-study heterogeneity. Publication bias was analyzed by Begg's funnel plot and Egger's regression test. The association was assessed by odds ratio (OR) with 95% confidence interval (CI). A total of 28 eligible studies were included in the meta-analysis. There was a significant inverse association between H. pylori infection (pooled OR, 0.57; 95% CI, 0.44-0.73) and EAC; CagA-positive H. pylori strains were less likely to be associated with EAC compared with CagA-negative strains (pooled OR, 0.64; 95% CI, 0.52-0.79). However, there was no statistically significant association between H. pylori/CagA-positive H. pylori strains infection and ESCC, and the pooled ORs were 1.16 (95% CI, 0.83-1.60) and 0.97 (95% CI, 0.79-1.19). But significant associations between CagA-positive H. pylori strains infection and ESCC risk were found in the stratified analysis of the study location (Asian and non-Asian), and the summary ORs were 0.74 (95% CI, 0.57-0.97) and 1.41 (95% CI, 1.02-1.94). H. pylori infection and CagA-positive strains are associated with decreased risk of EAC in the overall population. No significant association was found between H. pylori infection/CagA-positive strains and ESCC. But CagA-positive strains might have a positive association with ESCC in non-Asian population and an inverse association in Asian population.

Helicobacter Pylori and CagA: Relationships With Esophageal and Gastroduodenal Disorders in Iranian Patients

“…Moreover, some investigators have claimed that CagA positive H. pylori have an inverse association with esophageal adenocarcinoma (23). The present study has revealed that there was a significant difference between CagA positive and negative H. pylori in patients with some esophageal disorders.…”

Barrett's oesophagus: Frequency and prediction of dysplasia and cancer

“…This has suggested a potential relationship between these two opposing time trends. The most recent meta-analysis to examine the association between H. pylori infection and esophageal adenocarcinoma found an inverse relationship between H. pylori infection and esophageal adenocarcinoma (OR 0.57; 95% CI 0.44–0.73) [ 72 ]. A similar inverse relationship is seen in Barrett’s esophagus [ 73,74 ].…”

Customization of therapy for gastroesophageal adenocarcinoma patients

“…1). 3, 4, 5, 6 This trend is occurring in other regions as well and EGJ adenocarcinoma (adenocarcinomas that have their epicenter in the 10-cm segment encompassing the 5 cm above and 5 cm below EGJ) constitutes the major burden of GEACs 2 . Selecting appropriate therapy for GEAC may be possible after accurate stage is determined and patients discuss with a multidisciplinary team consisting of medical oncologists, surgeons, radiation oncologists, radiologists, pathologists and supportive care specialists.…”