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Observational Study
. 2024 Aug 7;30(29):3479-3487.
doi: 10.3748/wjg.v30.i29.3479.

Prevalence of Helicobacter pylori infection among patients with esophageal carcinoma

Miriam López-Gómez  1 , Maria Morales  2 , Rebeca Fuerte  3 , Marta Muñoz  4 , Pedro-David Delgado-López  5 , Jorge Francisco Gómez-Cerezo  6 , Enrique Casado  7
Affiliations
Observational Study

Prevalence of Helicobacter pylori infection among patients with esophageal carcinoma

Miriam López-Gómez et al. World J Gastroenterol. .

Abstract

Background: Helicobacter pylori (H. pylori) is a widespread microorganism related to gastric adenocarcinoma (AC). In contrast, it has been reported that an inverse association exists between H. pylori infection and esophageal carcinoma. The mechanisms underlying this supposedly protective effect remain controversial.

Aim: To determine the prevalence of H. pylori infection in esophageal carcinoma patients, we performed a retrospective observational study of esophageal tumors diagnosed in our hospital.

Methods: We retrospectively reviewed the prevalence of H. pylori infection in a cohort of patients diagnosed with esophageal carcinoma. Concomitant or previous proton pump inhibitor (PPI) usage was also recorded.

Results: A total of 89 patients with esophageal carcinoma (69 males, 77.5%), with a mean age of 66 years (range, 26-93 years) were included. AC was the most frequent pathological variant (n = 47, 52.8%), followed by squamous cell carcinoma (n = 37, 41.6%). Fourteen ACs (29.8%) originated in the gastroesophageal junction and 33 (70.2%) in the esophageal body. Overall, 54 patients (60.7%) presented at stages III and IV. Previous H. pylori infection occurred only in 4 patients (4.5%), 3 with AC (6.3% of all ACs) and 1 with squamous cell carcinoma (2.7% of all squamous cell tumors). All patients with previous H. pylori infection had stage III-IV. Only one patient had received prior H. pylori eradication therapy, whereas 86 (96.6%) had received previous or concomitant PPI treatment.

Conclusion: In our cohort of patients, and after histologic evaluation of paraffin-embedded primary tumors, we found a very low prevalence of previous H. pylori infection. We also reviewed the medical history of the patients, concluding that the majority had received or were on PPI treatment. The minimal prevalence of H. pylori infection found in this cohort of patients with esophageal carcinoma suggests a protective role.

Keywords: Carcinogenesis; Dysbiosis; Eradication; Esophageal tumor; Helicobacter pylori; Incidence; Microbiota; Proton pump inhibitors.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Red arrows show Helicobacter pylori in the lumen of gastric mucosa.
Figure 2
Figure 2
Gastroesophageal junction and esophageal tumors. A: Red arrow shows Helicobacter pylori in the lumen of an esophageal gland; B: Gastroesophageal junction (GEJ) tumor. Blue arrow shows squamous cells in normal esophageal tumors. Red arrows show Barrett’s esophagus. Orange arrows show GEJ adenocarcinoma; C: Esophageal adenocarcinoma.
Figure 3
Figure 3
Survival among Helicobacter pylori positive patients.
Figure 4
Figure 4
Duration of proton pump inhibitor treatment before cancer development. PPI: Proton pump inhibitor.
See this image and copyright information in PMC

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