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

• Published in: World journal of gastroenterology : WJG Vol. 22; no. 44; pp. 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: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.11.2016
• 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; Helicobacter pylori; Endoscopic submucosal dissection; Metachronous gastric cancer
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i44.9794

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.