Effect of Helicobacter pylori Eradication on Gastric Cancer Prevention: Updated Report From a Randomized Controlled Trial With 26.5 Years of Follow-up

Yan, Lingjun; Chen, Ying; Chen, Fa; Tao, Tao; Hu, Zhijian; Wang, Junzhuo; You, Jianwang; Wong, Benjamin C.Y.; Chen, Jianshun; W, Ye

doi:10.1053/j.gastro.2022.03.039

Cited by 118 publications

(69 citation statements)

References 32 publications

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“…The carbon urea breath test, stool antigen testing, and blood antibody tests are a few non-invasive tests for H. pylori infection that may be appropriate [ 3 ]. The spiral bacterium H. pylori , which has been linked to gastritis, stomach ulcers, and peptic ulcer disease, can be quickly diagnosed by the urea breath test [ 4 ]. It is predicated on H. pylori’s capacity to transform urea into ammonia and carbon dioxide.…”

Section: Discussionmentioning

confidence: 99%

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Systematic Review and Meta-Analysis on the Sensitivity and Specificity of 13C/14C-Urea Breath Tests in the Diagnosis of Helicobacter pylori Infection

Jambi

2022

Diagnostics

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Helicobacter pylori (H. pylori) continues to be a major health problem worldwide, causing considerable morbidity and mortality due to peptic ulcer disease and gastric cancer. The aim of the present systematic review and meta-analysis was to determine the sensitivity and specificity of 13C/14C-urea breath tests in the diagnosis of H. pylori infection. A PRISMA systematic search appraisal and meta-analysis were conducted. A systematic literature search of PubMed, Web of Science, EMBASE, Scopus, and Google Scholar was conducted up to August 2022. Generic, methodological and statistical data were extracted from the eligible studies, which reported the sensitivity and specificity of 13C/14C-urea breath tests in the diagnosis of H. pylori infection. A random effect meta-analysis was conducted on crude sensitivity and specificity of 13C/14C-urea breath test rates. Heterogeneity was assessed by Cochran's Q and I2 tests. The literature search yielded a total of 5267 studies. Of them, 41 articles were included in the final analysis, with a sample size ranging from 50 to 21857. The sensitivity and specificity of 13C/14C-urea breath tests in the diagnosis of H. pylori infection ranged between 64–100% and 60.5–100%, respectively. The current meta-analysis showed that the sensitivity points of estimate were 92.5% and 87.6%, according to the fixed and random models, respectively. In addition, the specificity points of estimate were 89.9% and 84.8%, according to the fixed and random models, respectively. There was high heterogeneity among the studies (I2 = 98.128 and 98.516 for the sensitivity and specificity, respectively, p-value < 0.001). The 13C/14C-urea breath tests are highly sensitive and specific for the diagnosis of H. pylori infection.

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Section: Discussionmentioning

confidence: 99%

“…More than 90% of duodenal ulcers and up to 80% of stomach ulcers are brought on by H. pylori [ 3 ]. Recent research has demonstrated a link between chronic H. pylori infection and the emergence of stomach cancer [ 4 ]. Additionally, H. pylori infection affects almost two-thirds of the world’s population [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic Review and Meta-Analysis on the Sensitivity and Specificity of 13C/14C-Urea Breath Tests in the Diagnosis of Helicobacter pylori Infection

Jambi

2022

Diagnostics

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“…Long-term infection by H. pylori is the strongest risk factor for both intestinal and diffuse gastric non-cardia carcinomas. In addition, H. pylori eradication is the standard therapy for gastric cancer prevention ( Yan et al, 2022 ). Similarly, persistent infection with oncogenic HPV types is strongly associated with the development of cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Dysbiosis: The first hit for digestive system cancer

et al. 2022

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Gastrointestinal cancer may be associated with dysbiosis, which is characterized by an alteration of the gut microbiota. Understanding the role of gut microbiota in the development of gastrointestinal cancer is useful for cancer prevention and gut microbiota-based therapy. However, the potential role of dysbiosis in the onset of tumorigenesis is not fully understood. While accumulating evidence has demonstrated the presence of dysbiosis in the intestinal microbiota of both healthy individuals and patients with various digestive system diseases, severe dysbiosis is often present in patients with digestive system cancer. Importantly, specific bacteria have been isolated from the fecal samples of these patients. Thus, the association between dysbiosis and the development of digestive system cancer cannot be ignored. A new model describing this relationship must be established. In this review, we postulate that dysbiosis serves as the first hit for the development of digestive system cancer. Dysbiosis-induced alterations, including inflammation, aberrant immune response, bacteria-produced genotoxins, and cellular stress response associated with genetic, epigenetic, and/or neoplastic changes, are second hits that speed carcinogenesis. This review explains the mechanisms for these four pathways and discusses gut microbiota-based therapies. The content included in this review will shed light on gut microbiota-based strategies for cancer prevention and therapy.

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“…In the current issue of Gastroenterology, Yan et al 9 provide an updated report of a prospective, randomized, placebocontrolled trial with a total follow-up time of 26.5 years. The trial was started in 1994 in Changle, Fujian Province, an area in China with high gastric cancer mortality.…”

mentioning

confidence: 99%

“…The study by Yan et al 9 has generated new insights into the long-term protective effect of H pylori eradication on gastric cancer. Because the study was conducted in a high gastric cancer incidence area in China, it is difficult to directly apply the findings to Western populations where gastric cancer incidence is low, 2,16 although observational studies have shown a similar risk reduction in Europe and the United States.…”

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confidence: 99%

Understanding the Protective Effect of Helicobacter pylori Eradication on Gastric Cancer After a Quarter Century: New Insights From an Old Trial

2022

Gastroenterology

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Effect of Helicobacter pylori Eradication on Gastric Cancer Prevention: Updated Report From a Randomized Controlled Trial With 26.5 Years of Follow-up

Cited by 118 publications

References 32 publications

Systematic Review and Meta-Analysis on the Sensitivity and Specificity of 13C/14C-Urea Breath Tests in the Diagnosis of Helicobacter pylori Infection

Systematic Review and Meta-Analysis on the Sensitivity and Specificity of 13C/14C-Urea Breath Tests in the Diagnosis of Helicobacter pylori Infection

Dysbiosis: The first hit for digestive system cancer

Understanding the Protective Effect of Helicobacter pylori Eradication on Gastric Cancer After a Quarter Century: New Insights From an Old Trial

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