Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis

Xiao, Shiyu; Li, Sizhu; Zhou, Liya; Jiang, Wenjun; Liu, Jin-Zhe

doi:10.1007/s00535-018-1513-8

Cited by 38 publications

(31 citation statements)

References 40 publications

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“…Gastric carcinoma is the third leading cause of cancer‐related death worldwide, and the strongest known risk factor for this devastating disease is infection with H pylori . Although accumulating evidence suggests the beneficial effect of H pylori eradication on preventing gastric cancer, the impact of antibiotics and PPIs involved in the regimen on gut microbiota has attracted much concern . This study investigated the short‐term and long‐term influences of H pylori eradication on both the gastric and gut microbiota in asymptomatic young adults.…”

Section: Discussionmentioning

confidence: 99%

“…22 Although accumulating evidence suggests the beneficial effect of H pylori eradication on preventing gastric cancer, the impact of antibiotics and PPIs involved in the regimen on gut microbiota has attracted much concern. 3, 23,24 This study investigated the short-term and long-term influences of H pylori eradication on both the gastric and gut microbiota in asymptomatic young adults. The alpha diversity of gastric microbiota gradually increased after the eradication of H pylori, and other bacteria, such…”

Section: Discussionmentioning

confidence: 99%

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The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

et al. 2019

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Background The eradication of Helicobacter pylori (H pylori) has been suggested to reduce the risk of gastric cancer, but its impact on the gut microbiota has attracted public attention. This study aimed to investigate the short‐term and long‐term effects of bismuth quadruple therapy on both gastric and fecal microbiota. Methods Ten asymptomatic young adults with H pylori‐related gastritis were treated with bismuth quadruple therapy for 14 days, and 7 age‐matched adults without H pylori infection were enrolled as healthy controls. Both fecal and gastric mucosa samples were collected from H pylori‐positive patients at weeks 0, 6, and 26, while fecal samples were collected from healthy controls. The gastric and gut microbiota were analyzed by 16S rRNA gene sequencing. Results The structure of the gastric microbiota was significantly changed after the eradication of H pylori with increased alpha diversity over time. The relative abundance of H pylori sharply decreased from more than 70% to nearly 0% after treatment, while some beneficial bacteria, such as Lactobacillus and Bifidobacterium, were increased. The microbial diversity of gut microbiota was higher in H pylori‐infected patients than in healthy controls, which tended to decrease after eradication. The potentially beneficial gut bacteria Blautia and Lachnoclostridium were enriched at week 26 compared to week 0, while the pathogenic Alistipes were depleted to a level close to that of the healthy controls. Conclusions Bismuth quadruple therapy for H pylori eradication can restore the diversity of gastric microbiota with enrichment of beneficial bacteria. The composition of gut microbiota after H pylori eradication trends toward healthy status instead of becoming dysbiotic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

et al. 2019

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“…[4][5][6][7][8][9][10] The preventive effects of H. pylori eradication are considered to be influenced by the following factors: (1) whether the MGC includes dysplasia and GC; (2) whether the lesions that underwent ER include not only GC but also dysplasia; (3) whether H. pylori-eradicated and naturally eradicated patients are treated identically as H. pylori-negative cases; (4) the study design; (5) the methodological quality of enrolled studies; and others. 9 Even taking these factors into consideration, an effect was clearly detected, and its size was similar among these meta-analyses (RR, 0.39 to 0.52). Two meta-analyses reported that the magnitude of the protective effect induced by eradication is greater among individuals with a higher baseline GC risk, such as patients who have undergone ER of early GC, compared to primary GC patients.…”

Section: Review Of Meta-analysesmentioning

confidence: 99%

“…2 Similarly, in 2014 the International Agency for Research on Cancer Working Group Report recommended that all countries explore the possibility of introducing population-based H. pylori screening and treatment programs as a strategy for GC prevention. 3 To date, both meta-analyses [4][5][6][7][8][9][10] and randomized controlled trials (RCTs) 11,12 have found that H. pylori eradication appears to reduce the risk of GC. However, some retrospective studies 13,14 and a prospective open-label trial 15 have shown that H. pylori eradication did not reduce the incidence of metachronous GC (MGC) in patients who underwent endoscopic resection (ER).…”

Section: Introductionmentioning

confidence: 99%

Preventing Metachronous Gastric Cancer after the Endoscopic Resection of Gastric Epithelial Neoplasia: Roles of <i>Helicobacter pylori</i> Eradication and Aspirin

et al. 2020

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Whether Helicobacter pylori eradication actually reduces the risk of metachronous gastric cancer (MGC) development remains a controversial question. In this review, we addressed this topic by reviewing the results of clinical investigations and molecular pathological analyses of the roles of H. pylori eradication and aspirin administration in the prevention of MGC. In regard to the clinical studies, the results of metaanalyses and randomized control trials differ from those of retrospective studies: the former trials show that H. pylori eradication has a preventive effect on MGC, while the latter studies do not. This discrepancy may be at least partly attributable to differences in the follow-up periods: H. pylori eradication is more likely to prevent MGC over a long-term followup period (≥5 years) than over a short-term follow-up period. In addition, many studies have shown that aspirin may have an additive effect on MGC-risk reduction after H. pylori eradication has been achieved. Both H. pylori eradication and aspirin use induce molecular alterations in the atrophic gastritis mucosa but not in the intestinal metaplasia. Unfortunately, the molecular pathological analyses of these interventions have been limited by short follow-up periods. Therefore, a long-term prospective cohort is needed to clarify the changes in molecular events caused by these interventions.

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“…Nevertheless, several meta-analyses concluded that H. pylori eradication could reduce the incidence of metachronous gastric cancer significantly, therefore preventing against metachronous gastric cancer in patients who have undergone endoscopic resection [41][42][43][44]. Although it is possible to develop metachronous gastric cancer a er successful eradication of H. pylori, H. pylori eradication a er endoscopic resection of EGC is still recommended in the Maastricht consensus report and the Guidelines of the Japanese Gastroenterological Society [45,46].…”

Section: Effect Of H Pylori Eradication On the Development Of Metachmentioning

confidence: 99%

Helicobacter pylori Infection following Endoscopic Resection of Early Gastric Cancer

2019

BioMed Research International

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e role of Helicobacter pylori (H. pylori) infection in patients following endoscopic resection of early gastric cancer (EGC) remains unclear. is article presents a review of literature published in the past 15 years. H. pylori-mediated persistent methylation levels are associated with the development of metachronous gastric cancer. e methylation of certain speci c genes can be used to identify patients with a high risk of metachronous gastric cancer even a er H. pylori eradication. H. pylori eradication a er endoscopic resection should be performed as early as possible for eradication success and prevention of metachronous precancerous lesions. Although whether the eradication of H. pylori could prevent the development of metachronous cancer a er endoscopic resection is controversial, several meta-analyses concluded that H. pylori eradication could reduce the incidence of metachronous gastric cancer signi cantly. In addition, H. pylori eradication in gastric cancer survivors a er endoscopic resection could reduce healthcare cost and save lives in a cost-e ective way. Taken together, H. pylori eradication a er endoscopic resection of EGC is recommended as prevention for metachronous precancerous lesions and metachronous gastric cancer.

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Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis

Cited by 38 publications

References 40 publications

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

The eradication of Helicobacter pylori restores rather than disturbs the gastrointestinal microbiota in asymptomatic young adults

Preventing Metachronous Gastric Cancer after the Endoscopic Resection of Gastric Epithelial Neoplasia: Roles of <i>Helicobacter pylori</i> Eradication and Aspirin

Helicobacter pylori Infection following Endoscopic Resection of Early Gastric Cancer

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