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Gastric Cancer. 2016 Jan;19(1):166-75. doi: 10.1007/s10120-015-0462-7. Epub 2015 Jan 22.

Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis.

Author information

  • 1Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.
  • 2Institution of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, China.
  • 3Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
  • 4Institution of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, China. simonlixiao@126.com.
  • 5Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China. zhou767@hotmail.com.

Abstract

BACKGROUND:

The effect of Helicobacter pylori (H. pylori) eradication on gastric cancer (GC) prevention is controversial. Intestinal metaplasia (IM) seems to be a "point of no return" in the precancerous cascade. We performed a meta-analysis of randomized controlled trials (RCTs) to illustrate this issue.

MATERIALS AND METHODS:

The MEDLINE, EMBASE, Cochrane Library were searched for relevant RCTs that were published in any language up to March 2014. By dividing participants into subgroups based on their baseline diagnoses as group <IM (normal, non-atrophic gastritis, atrophic gastritis) and group ≥ IM(intestinal metaplasia, dysplasia), the relative risk (RR) of GC in each study compared treatment group with control group were pooled using Mantel-Haenszel fixed-effect model and publication bias analyses were performed.

RESULTS:

Ten studies from eight RCTs were included in this analysis, for a total of 7,955 participants. H. pylori treatment compared with control significantly reduced the risk of GC, with a pooled RR of 0.64 (95% CI, 0.48-0.85). Subgroup analysis for patients with non-atrophic gastritis, atrophic gastritis (<IM) yielded a similar results (RR = 0.25, 95% CI, 0.08-0.81). But this difference was not observed in patients with intestinal metaplasia, dysplasia (≥ IM) (RR = 0.88; 95% CI, 0.59-1.31).

CONCLUSIONS:

Our results suggested that patients with Intestinal metaplasia or dysplasia could not benefit from the H. pylori treatment on the risk of GC.

KEYWORDS:

Gastric cancer; Helicobacter pylori treatment; Precancerous lesions

PMID:
25609452
DOI:
10.1007/s10120-015-0462-7
[PubMed - indexed for MEDLINE]
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