Association between Helicobacter pylori Infection and Pancreatic Cancer. A Cumulative Meta-Analysis

摘要

Context Infection with Helicobacterpylori (H. pylori) has been implicated in the etiopathogenesis of variousmalignant conditions. Notwithstanding, its etiological association withpancreatic cancer remains inconclusive. Studies focusing on the relationship betweenH. pylori infection and pancreatic cancer risk have yielded conflictingresults. Objective The aim of this study was to obtain a reliableestimate of the risk of H. pylori infection in causing pancreaticcancer, by performing a meta-analysis of the existing observational studiesevaluating the association. Methods/Statistics Observational studiescomparing the prevalence of H. pylori infection in patients with pancreaticcancer and healthy controls, conducted in adult populations and published inall languages, were identified through systematic search in the MEDLINE andEMBASE up to April 2010. H. pylori infection was confirmed byserological testing using an antigen-specific enzyme-linked immunosorbentassay. Pooled adjusted odds ratios (AOR) and associated 95% confidenceintervals (CI) were obtained by using a DerSimonian and Laird random-effectsmodel. Results Six studies involving a total of 2,335 patients met oureligibility criteria. A significant association between H. pyloriseropositivity and development of pancreatic cancer (AOR 1.38, 95% CI: 1.08-1.75;P=0.009) was seen. No significant association was seen on pooled analysis ofthe three studies assessing the relationship between cytotoxin-associated geneA (CagA) positivity and pancreatic cancer. A cumulative meta-analysis suggesteda reducing, albeit statistically significant association as the evidence wasaccumulated. Conclusions The pooled data suggests an association betweeninfection with H. pylori and the development of pancreatic cancer.Further research is needed to confirm our findings.