Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 May 21;20(19):5903-11.
doi: 10.3748/wjg.v20.i19.5903.

Histological changes of gastric mucosa after Helicobacter pylori eradication: a systematic review and meta-analysis

Yan-Jun Kong  1 , Hong-Gang Yi  1 , Jun-Cheng Dai  1 , Mu-Xin Wei  1
Affiliations
Meta-Analysis

Histological changes of gastric mucosa after Helicobacter pylori eradication: a systematic review and meta-analysis

Yan-Jun Kong et al. World J Gastroenterol. .

Abstract

Aim: To systematically review pathological changes of gastric mucosa in gastric atrophy (GA) and intestinal metaplasia (IM) after Helicobacter pylori (H. pylori) eradication.

Methods: A systematic search was made of PubMed, Web of Science, EMBASE, ClinicalTrials.gov, OVID and the Cochran Library databases for articles published before March 2013 pertaining to H. pylori and gastric premalignant lesions. Relevant outcomes from articles included in the meta-analysis were combined using Review Manager 5.2 software. A Begg's test was applied to test for publication bias using STATA 11 software. χ(2) and I(2) analyses were used to assess heterogeneity. Analysis of data with no heterogeneity (P > 0.1, I (2) < 25%) was carried out with a fixed effects model, otherwise the causes of heterogeneity were first analyzed and then a random effects model was applied.

Results: The results of the meta-analysis showed that the pooled weighted mean difference (WMD) with 95%CI was 0.23 (0.18-0.29) between eradication and non-eradication of H. pylori infection in antral IM with a significant overall effect (Z = 8.19; P <0.00001) and no significant heterogeneity (χ(2) = 27.54, I(2) = 16%). The pooled WMD with 95%CI was -0.01 (-0.04-0.02) for IM in the corpus with no overall effect (Z = 0.66) or heterogeneity (χ(2) = 14.87, I(2) =0%) (fixed effects model). In antral GA, the pooled WMD with 95% CI was 0.25 (0.15-0.35) with a significant overall effect (Z = 4.78; P < 0.00001) and significant heterogeneity (χ(2) = 86.12, I(2) = 71%; P < 0.00001). The pooled WMD with 95% CI for GA of the corpus was 0.14 (0.04-0.24) with a significant overall effect (Z = 2.67; P = 0.008) and significant heterogeneity (χ(2) = 44.79, I(2) = 62%; P = 0.0003) (random effects model).

Conclusion: H. pylori eradication strongly correlates with improvement in IM in the antrum and GA in the corpus and antrum of the stomach.

Keywords: Gastric atrophy; Gastric mucosa; Helicobacter pylori eradication; Intestinal metaplasia; Meta-analysis; Pathological changes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram of the selection of included studies. H. pylori: Helicobacter pylori; IM: Intestinal metaplasia.
Figure 2
Figure 2
Forest plot comparing intestinal metaplasia in the antrum (A) and the corpus (B).
Figure 3
Figure 3
Forest plot comparing gastric atrophy in the antrum (A) and the corpus (B).
See this image and copyright information in PMC

References

    1. Oliveira C, Seruca R, Carneiro F. Genetics, pathology, and clinics of familial gastric cancer. Int J Surg Pathol. 2006;14:21–33. - PubMed
    1. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49. - PubMed
    1. Correa P, Haenszel W, Cuello C, Tannenbaum S, Archer M. A model for gastric cancer epidemiology. Lancet. 1975;2:58–60. - PubMed
    1. Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer. 2001;37 Suppl 8:S4–66. - PubMed
    1. Parkin DM. International variation. Oncogene. 2004;23:6329–6340. - PubMed

MeSH terms

Substances