Helicobacter pylori, gastric cancer and other gastrointestinal malignancies

Abstract

In a retrospective study performed in California, U.S.A., ca. 3% of patients with gastric intestinal metaplasia (GIM) developed gastric cancer (GC) within a median time period of 4.6 years after diagnosis of GIM. This observation stresses the importance of targeted surveillance even in regions with a low GC prevalence. Patients with alcoholic liver disease as well as survivors of colorectal and lobular breast cancer were found to be at increased risk of secondary GC. A population-based Chinese study confirmed "serologic biopsy" as a useful screening tool for stratifying the individual risk of developing GC. Concerning GC therapy, a post hoc analysis of the MAGIC trial reported that regression of lymph node metastases, but not the tumor regression itself, predicts overall survival. Furthermore, in patients with high microsatellite instable tumors, perioperative chemotherapy leads to an increased risk of mortality. Two studies confirmed that eradication therapy is worthwhile as an initial treatment for gastric mucosa-associated lymphoid tissue (MALT) lymphoma irrespective of the H. pylori infection status and stage. An increased risk of a second primary malignancy including GC was observed in these patients treated with immuno/chemotherapy but not in patients treated solely with an H. pylori eradication treatment. With respect to gastrointestinal malignancies other than GC, discrepant data have been published regarding the association of H. pylori with pancreatic cancer whereas no association has been reported with esophageal squamous cell carcinoma. The majority of published studies still support an association of H. pylori with colon neoplasms.

Helicobacter pylori infection and its related factors in junior high school students in Nagano Prefecture, Japan

“…Although the prevalence of H. pylori is declining in the United States and other Western countries, the incidence of esophageal adenocarcinoma, asthma, and allergies is on the rise. An increasing number of studies have suggested an inverse association between H. pylori and these diseases . Although a causal relationship has not been established, it is likely that the increase in these diseases can be attributed, in part, to the disappearance of H. pylori .…”

The role of microbiota in the development of colorectal cancer

“…H. pylori is a major factor in the development of stomach disorders and gastric cancer (GC) . Some reports have indicated a potential relationship between H. pylori infection and colorectal neoplasms; however, this has been disputed by others.…”

Synchronous MALT lymphoma of the colon and stomach and regression after eradication ofStrongyloides stercoralisandHelicobacter pylori

“…It is therefore possible that H. pylori , S. stercoralis or another unidentified mechanism was responsible for the colonic MALT lymphoma 35 . H. pylori , a known cause of gastric MALT lymphoma and gastric and colorectal adenocarcinomas, could have potentiated the development of colonic MALT lymphoma 36. However, this possibility is relatively unlikely because it is generally thought that extragastric MALT lymphomas are unrelated to H. pylori infection, but are rather being associated with other organisms that commonly colonise or infect the colon like S. stercoralis 6 29 37–40.…”