Association between Helicobacter pylori status and metachronous gastric cancer after endoscopic resection

AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric cancer(EGC) and risk factors of MGC. METHODS The authors retrospectively reviewed t...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2016-11, Vol.22 (44), p.9794-9802
Main Authors: Kim, Sung Bum, Lee, Si Hyung, Bae, Seung Il, Jeong, Yo Han, Sohn, Se Hoon, Kim, Kyeong Ok, Jang, Byung Ik, Kim, Tae Nyeun
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Atrophy
Drug Therapy, Combination
Endoscopic Mucosal Resection - adverse effects
Female
Gastrectomy - adverse effects
Gastrectomy - methods
Gastric Mucosa - microbiology
Gastric Mucosa - pathology
Gastric Mucosa - surgery
Gastroscopy - adverse effects
Helicobacter Infections - complications
Helicobacter Infections - diagnosis
Helicobacter Infections - drug therapy
Helicobacter Infections - microbiology
Helicobacter pylori - drug effects
Helicobacter pylori - isolation & purification
Hospitals, University
Humans
Male
Metaplasia
Middle Aged
Neoplasms, Second Primary
Proton Pump Inhibitors - therapeutic use
Republic of Korea
Retrospective Studies
Retrospective Study
Risk Factors
Stomach Neoplasms - microbiology
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Time Factors
Treatment Outcome
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Summary:AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric cancer(EGC) and risk factors of MGC. METHODS The authors retrospectively reviewed the medical records of 433 patients(441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group(n = 257) and the H. pylori non-tested group(n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup(n = 120), the H. pylori-persistent subgroup(n = 42), and the H. pylori-negative subgroup(n = 95). Incidences of MGC and risk factors of MGC were identified.RESULTS Median follow-up duration after ESD was 30.00 mo(range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group(7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group(P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients. CONCLUSION H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i44.9794