Long-Term Effects of Helicobacter pylori Eradication on Metachronous Gastric Cancer Development
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Background/Aims: Gastric mucosal atrophy and intestinal metaplasia due to Helicobacter pylori infection are the main precursor lesions of gastric cancer. The aim of this study was to evaluate the long-term effects of H. pylori eradication on the progression of precancerous lesions to metachronous cancer after endoscopic resection of early gastric cancer (EGC). Methods: Patients who underwent endoscopic resection of EGC were retrospectively reviewed. Changes in precancerous lesions and development of metachronous cancer were compared according to H. pylori eradication and final infection status. Results: In total, 565 patients were followed for over 5 years after endoscopic resection of EGC. The grade of atrophy on corpus was significantly lower in the H. pylori-eradicated group than in the persistent group during follow-up (p=0.029). In patients <70 years of age, the cumulative incidence rate of metachronous cancer was significantly lower in the H. pylori-eradicated group than in the persistent group (p=0.018). Age was an independent risk factor for metachronous cancer development. Conclusions: H. pylori eradication might prevent the development of metachronous cancer in patients <70 years of age by delaying the progression of precancerous lesions after endoscopic resection of EGC.
Abstract
Background/Aims: Gastric mucosal atrophy and intestinal metaplasia due to Helicobacter pylori infection are the main precursor lesions of gastric cancer. The aim of this study was to evaluate the long-term effects of H. pylori eradication on the progression of precancerous lesions to metachronous cancer after endoscopic resection of early gastric cancer (EGC). Methods: Patients who underwent endoscopic resection of EGC were retrospectively reviewed. Changes in precancerous lesions and development of metachronous cancer were compared according to H. pylori eradication and final infection status. Results: In total, 565 patients were followed for over 5 years after endoscopic resection of EGC. The grade of atrophy on corpus was significantly lower in the H. pylori-eradicated group than in the persistent group during follow-up (p=0.029). In patients <70 years of age, the cumulative incidence rate of metachronous cancer was significantly lower in the H. pylori-eradicated group than in the persistent group (p=0.018). Age was an independent risk factor for metachronous cancer development. Conclusions: H. pylori eradication might prevent the development of metachronous cancer in patients <70 years of age by delaying the progression of precancerous lesions after endoscopic resection of EGC.
참고문헌 (20)
- "WHO statistical information system" (2017)[URL]
- Chung IK, "Therapeutic outcomes in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study", Gastrointest Endosc, 69, pp.1228~1235 (2009)[DOI]
- Isomoto H, "Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study", Gut, 58, pp.331~336 (2009)[DOI]
- Correa P, "Carcinogenesis of Helicobacter pylori", Gastroenterology, 133, pp.659~672 (2007)[DOI]
- Rokkas T, "The long-term impact of Helicobacter pylori eradication on gastric histology: a systematic review and meta-analysis", Helicobacter, 12(Suppl 2), pp.32~38 (2007)[DOI]
- Wang J, "Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis", Digestion, 83, pp.253~260 (2011)[DOI]
- Toyokawa T, "Eradication of Helicobacter pylori infection improved gastric mucosal atrophy and prevented progression of intestinal metaplasia, especially in the elderly population: a long-term prospective cohort study", J Gastroenterol Hepatol, 25, pp.544~547 (2010)[DOI]
- Ito M, "Helicobacter pylori eradication therapy improves atrophic gastritis and intestinal metaplasia: a 5-year prospective study of patients with atrophic gastritis", Aliment Pharmacol Ther, 16, pp.1449~1456 (2002)[DOI]
- Kong YJ, "Histological changes of gastric mucosa after Helicobacter pylori eradication: a systematic review and meta-analysis", World J Gastroenterol, 20, pp.5903~5911 (2014)[DOI]
- Ohkusa T, "Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylori was eradicated", Ann Intern Med, 134, pp.380~386 (2001)[DOI]
- Fukase K, "Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial", Lancet, 372, pp.392~397 (2008)[DOI]
- Yoon SB, "Effect of Helicobacter pylori eradication on metachronous gastric cancer after endoscopic resection of gastric tumors: a meta-analysis", Helicobacter, 19, pp.243~248 (2014)[DOI]
- Choi J, "Eradication of Helicobacter pylori after endoscopic resection of gastric tumors does not reduce incidence of metachronous gastric carcinoma", Clin Gastroenterol Hepatol, 12, pp.793~800 (2014)[DOI]
- Jung S, "Preventing metachronous gastric lesions after endoscopic submucosal dissection through Helicobacter pylori eradication", J Gastroenterol Hepatol, 30, pp.75~81 (2015)[DOI]
- Japanese Gastric Cancer Association, "Japanese classification of gastric carcinoma: 3rd English edition", Gastric Cancer, 14, pp.101~112 (2011)[DOI]
- Stolte M, "The updated Sydney system: classification and grading of gastritis as the basis of diagnosis and treatment", Can J Gastroenterol, 15, pp.591~598 (2001)[DOI]
- Wong BC, "Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial", JAMA, 291, pp.187~194 (2004)[DOI]
- Fuccio L, "Systematic review: Helicobacter pylori eradication for the prevention of gastric cancer", Aliment Pharmacol Ther, 25, pp.133~141 (2007)
- Kim YI, "The association between Helicobacter pylori status and incidence of metachronous gastric cancer after endoscopic resection of early gastric cancer", Helicobacter, 19, pp.194~201 (2014)[DOI]
- Kwon YH, "Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients", Aliment Pharmacol Ther, 39, pp.609~618 (2014)[DOI]
