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. 2018 Mar 15;12(2):133-141.
doi: 10.5009/gnl17073.

Long-Term Effects of Helicobacter pylori Eradication on Metachronous Gastric Cancer Development

Seung Jun Han  1 , Sang Gyun Kim  1 , Joo Hyun Lim  2 , Ji Min Choi  2 , Sooyeon Oh  1 , Jae Yong Park  1 , Jung Kim  1 , Joo Sung Kim  1 , Hyun Chae Jung  1
Affiliations

Long-Term Effects of Helicobacter pylori Eradication on Metachronous Gastric Cancer Development

Seung Jun Han et al. Gut Liver. .

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.

Keywords: Atrophy; Helicobacter pylori; Metaplasia; Stomach neoplasms.

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Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
The proportions of patients with precancerous lesions. (A) Antral mucosal atrophy at baseline. (B) Antral mucosal atrophy at the last follow-up. (C) At baseline, the proportion of patients with corpus mucosal atrophy was higher in the eradicated group than in the negative group (p=0.011). (D) At the last follow-up, the proportion of patients with corpus mucosal atrophy was higher in the persistent group than in the negative and eradicated groups (p<0.001 and p=0.015, respectively). (E) Antral intestinal metaplasia at baseline. (F) Antral intestinal metaplasia at the last follow-up. (G) Corpus intestinal metaplasia at baseline. (H) Corpus intestinal metaplasia at the last follow-up. p-values are greater than 0.05 unless otherwise stated. N, negative group; E, eradicated group; P, persistent group.
Fig. 2
Fig. 2
Cumulative incidence of metachronous cancer. (A) The cumulative incidence rate of metachronous cancer was higher in the negative group than in the eradicated group (p=0.004). (B) In patients less than 70 years of age, the cumulative incidence rate of metachronous cancer development was lower in the eradicated group than in the negative and persistent groups (p=0.001 and p=0.018, respectively). p-values are greater than 0.05 unless otherwise stated. N, negative group; E, eradicated group; P, persistent group.
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