Helicobacter pyloriEradication Suppresses Metachronous Gastric Cancer and Cyclooxygenase-2 Expression after Endoscopic Resection of Early Gastric Cancer

Abstract

Background/Aims: The impact of Helicobacter pylori (H. pylori) eradication after endoscopic resection (ER) of early gastric cancer (EGC) has not been fully evaluated. We tried to find out the effect of H. pylori eradication therapy on the development of metachronous gastric cancers and changes in Cyclooxygenase-2 (COX-2) expression following attempts to eradicate H. pylori after ER of EGC. Materials and Methods: We eradicated H. pylori in the patients with EGC after ER. Biopsy samples were taken according to the follow-up schedules for surveillance after ER. Results: Fifty five patients were enrolled and finished the follow up schedules. Of the 55, 28 were successfully treated H. pylori infection, and the other 27 were failed eradication of H. pylori. The mean follow-up period was 60.8 months. Five in the H. pylori ongoing infection group developed metachronous gastric cancer, whereas no new gastric cancers were found in the 28 eradication group (P=0.023). COX-2 expression in the eradication group was significantly decreased (1.4±0.2, n=28), compared to that in H. pylori ongoing infection group (3.0±0.4, n=27, P=0.0001) after the follow-up. Conclusions: The eradication of H. pylori seems to have a preventative effect on the development of metachronous adenocarcinomas and a suppressive effect on COX-2 expression in the patients after ER for EGC. (Korean J Helicobacter Upper Gastrointest Res 2011;11:117-123)

Effect of Helicobacter pylori Eradication on Metachronous Gastric Cancer after Endoscopic Resection of Gastric Tumors: A Meta‐Analysis

“…Finally, 13 studies were considered to be appropriate for this meta-analysis [16][17][18][22][23][24][25][26][27][28][29][30][31]. The main characteristics of the papers are shown in Table 1.…”

“…The baseline characteristics of the study patients in the two prospective randomized trials are summarized in Table 2. The rest were observational or retrospective studies [22][23][24][25][26][27][28][29][30][31]. Among the 13 studies, six were conducted in Japan [16,17,22,23,26,27] and seven in Korea [18,24,25,[28][29][30][31].…”

Effect of Helicobacter pylori eradication on the incidence of gastric cancer: a systematic review and meta-analysis

“…The search strategy yielded 1529 potentially eligible studies from MEDLINE and 54 studies from Ichushi-Web. Twenty-eight studies from MEDLINE and no studies from Ichushi-Web were selected from the extracted studies, and four studies [48][49][50][51] were included based on the manual search. Thus, 32 studies were included in the meta-analysis ( Fig.…”

“…As only one study from Japan employed radiological method for screening, I excluded this study throughout the subgroup analyses to align detection methodology. Among all 31 studies, 16 were conducted in Japan [24-30, 32-38, 48, 49], 10 in Korea [39][40][41][42][43][44][45][46][47]50], 4 in China [20][21][22][23], and 1 in Colombia [51]. The subgroup of studies carried out in Japan had the lowest OR (OR 0.39; 95% CI 0.31-0.49), followed by Korea (OR 0.47; 95% CI 0.34-0.66), China (OR 0.62; 95% CI 0.42-0.91), and Colombia (OR 1.21; 95% CI 0.32-4.52) (Fig.…”