Eradication ofHelicobacter pyloriand Gastric Cancer: A Systematic Review and Meta-analysis of Cohort Studies

Doorakkers, Eva; Lagergren, Jesper; Engstrand, Lars; Brusselaers, Nele

doi:10.1093/jnci/djw132

Cited by 90 publications

(71 citation statements)

References 57 publications

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“…Moreover, the risk of gastric cancer in H. pylori -uninfected subjects is extremely low in Japan [24]. Thus, the purpose of gastric cancer screening using serum test is to detect strictly H. pylori -infected subjects and H. pylori post-eradication subjects because eradiation merely reduces the incidence of gastric cancer to 54% [27]. In this study, 18 of 33 (54.5%) post-eradication subjects were classified into Group C using the ABC method before eradication, suggesting that they were originally a relatively high-risk group, and periodic endoscopic surveillance should be performed even after eradication.…”

Section: Discussionmentioning

confidence: 99%

Cutoff Pepsinogen Level for Predicting Unintendedly Eradicated Cases of Helicobacter pylori Infection in Subjects with Seemingly Normal Pepsinogen Levels

Kishikawa¹,

Kimura²,

Ito³

et al. 2017

Digestion

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Backgrounds/Aims: In the ABC method, which is a method for risk stratification of gastric cancer using serum anti-Helicobacter pylori antibody and pepsinogen (PG) test, subjects with normal PG and seronegative for H. pylori are named as “Group A” and are regarded as having a low risk of gastric cancer. These “Group A” subjects include unintentionally eradicated cases at relatively high risk, and this study aimed to identify these subjects. Methods: Of the 109 subjects, 76 were classified as uninfected Group A subjects with negative histologic H. pylori infection and no histologic and endoscopic atrophy, and 33 subjects were classified serologically as Group A after successful eradication, which are serologically equal to the unintendedly eradicated cases in Group A. The usefulness of measuring PG levels to detect post-eradication cases was validated by using a receiver operating characteristic (ROC) curve analysis. Results: The area under the ROC curve for PGI level was 0.736 ± 0.06 (p < 0.01; cutoff value, 37.0 ng/mL; sensitivity, 77.6%; specificity, 72.7%), and that for the PGI/II ratio was 0.660 ± 0.06 (p < 0.01; cutoff value, 5.1; sensitivity, 84.2%; specificity, 43.4%). Conclusion: PGI levels of ≤37 ng/mL and PGI/II ratios of ≤5.1 effectively identified unintendedly eradicated cases in Group A.

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Section: Discussionmentioning

confidence: 99%

Cutoff Pepsinogen Level for Predicting Unintendedly Eradicated Cases of Helicobacter pylori Infection in Subjects with Seemingly Normal Pepsinogen Levels

Kishikawa¹,

Kimura²,

Ito³

et al. 2017

Digestion

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“…5 Systematic reviews and meta-analyses have demonstrated that the eradication of H. pylori can effectively reduce the incidence of GC by 34%-54%. 6,7 Other studies have found that eradication of H. pylori can partially reverse gastric atrophy but cannot reverse intestinal metaplasia. 8,9 Therefore, the eradication of H. pylori cannot completely prevent the occurrence of GC.…”

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confidence: 99%

The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study

Zhang

Yao

et al. 2020

J of Digest Diseases

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Objective: To evaluate the relationship between gastric cancer (GC) and precancerous lesions and bile reflux.Methods: Medical records of 30 465 participants who underwent gastroscopy between January and December 2018 in our center were reviewed. Their age, sex, time of endoscopy, endoscopic/histologic diagnosis and grade of bile reflux were recorded. The participants were further divided into the chronic gastritis group (n = 27 807), a precancerous lesion group (n = 1943) and a GC group (n = 715). The χ 2 tests and hierarchical analyses were performed.Results: Patients aged 18-27 years had a higher bile reflux rate than those aged 28-37 and 68-75 years (P < 0.001), while it did not differ between patients aged <50 years and those over 50 years (P = 0.639). It was lower in men than in women (P < 0.001). The bile reflux rate did not differ in terms of months, seasons and half of the year (all P > 0.05), but differed between morning and afternoon when they underwent the endoscopy (P = 0.000). There was an interrelationship between the severity of gastric mucosal disease and bile reflux grade (r = 0.171). After excluding the effects of sex, age and time of endoscopy on bile reflux, bile reflux rate in chronic gastritis and precancerous lesions was lower than in gastric cancer (P < 0.01).Conclusions: Bile reflux may be a risk factor for gastric cancer and precancerous lesions. A high grade of bile reflux may be associated with the progression of gastric mucosal diseases.bile reflux, gastric neoplasms, gastritis, intestinal metaplasia, precancerous lesions | INTRODUCTIONAs the fifth most common malignant tumor worldwide, more than one million new cases of gastric cancer (GC) were estimated to be diagnosed in 2018; while the cancer-related mortality rate of GC is the third highest (equivalent to one in every 12 deaths worldwide). 1 In China the incidence and mortality of GC are also high. 2 According to the Correa model, despite its complex etiology GC usually begins with atrophic gastritis, intestinal metaplasia or atypical hyperplasia, and progresses to carcinogenesis. 3 Helicobacter pylori (H. pylori) infection, patient's age, sex, * These authors contributed equally to this work.

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“…In addition, these results need to be validated in other ethnic groups. Although the eradication of H. pylori reduces gastric cancer risk, the risk reduction is as low as 30%‐40%, and a substantial proportion of the subjects develop gastric cancer even after H. pylori eradiation . Because post‐eradication gastric cancer is an important clinical problem, the development of a risk‐prediction system is necessary to identify high‐risk individuals with current or past H. pylori infection.…”

Section: Discussionmentioning

confidence: 99%

“…Although the eradication of H. pylori reduces gastric cancer risk, the risk reduction is as low as 30%-40%, and a substantial proportion of the subjects develop gastric cancer even after H. pylori eradiation. 55 Because post-eradication gastric cancer is an important clinical problem, the development of a riskprediction system is necessary to identify high-risk individuals with current or past H. pylori infection. We hope our findings will contribute to the elucidation of the molecular pathology of gastric cancer and the implementation of personalized medical care for this disease.…”

Section: Discussionmentioning

confidence: 99%

Genome‐wide association study identifies gastric cancer susceptibility loci at 12q24.11‐12 and 20q11.21

Tanikawa

Kamatani

Toyoshima³

et al. 2018

Cancer Science

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Gastric cancer is the third leading cause of cancer mortality in Japan and worldwide. Although previous studies identify various genetic variations associated with gastric cancer, host genetic factors are largely unidentified. To identify novel gastric cancer loci in the Japanese population, herein, we carried out a large‐scale genome‐wide association study using 6171 cases and 27 178 controls followed by three replication analyses. Analysis using a total of 11 507 cases and 38 904 controls identified two novel loci on 12q24.11‐12 (rs6490061, P = 3.20 × 10−8 with an odds ratio [OR] of 0.905) and 20q11.21 (rs2376549, P = 8.11 × 10−10 with an OR of 1.109). rs6490061 is located at intron 19 of the CUX2 gene, and its expression was suppressed by Helicobacter pylori infection. rs2376549 is included within the gene cluster of DEFB families that encode antibacterial peptides. We also found a significant association of rs7849280 in the ABO gene locus on 9q34.2 (P = 2.64 × 10−13 with an OR of 1.148). CUX2 and ABO expression in gastric mucosal tissues was significantly associated with rs6490061 and rs7849280 (P = 0.0153 and 8.00 × 10−11), respectively. Our findings show the crucial roles of genetic variations in the pathogenesis of gastric cancer.

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Eradication ofHelicobacter pyloriand Gastric Cancer: A Systematic Review and Meta-analysis of Cohort Studies

Abstract: This systematic review and meta-analysis indicates that eradication therapy for H. pylori prevents gastric cancer. There was insufficient literature for meta-analysis of MALT lymphoma or esophageal cancer.

Cited by 90 publications

References 57 publications

Cutoff Pepsinogen Level for Predicting Unintendedly Eradicated Cases of <b><i>Helicobacter pylori</i></b> Infection in Subjects with Seemingly Normal Pepsinogen Levels

Cutoff Pepsinogen Level for Predicting Unintendedly Eradicated Cases of <b><i>Helicobacter pylori</i></b> Infection in Subjects with Seemingly Normal Pepsinogen Levels

The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study

Genome‐wide association study identifies gastric cancer susceptibility loci at 12q24.11‐12 and 20q11.21

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