Eradication of Helicobacter pylori reduces metachronous gastric cancer after endoscopic resection of early gastric cancer

摘要

Background/Aims: Although some studies have shown improvement of precancerous lesions and a decrease of metachronous gastric cancer after eradication of H. pylori, this is still controversial. Methodology: We identified 74 patients with early gastric cancer and who had their H. pylori eradicated after undergoing endoscopic resection between September, 2003 and September, 2010. The endoscopic biopsy specimens, campylobacter-like organism test and urea breath test were reviewed. Relapse of gastric cancer was assessed from medical records. Results: Among the 74 patients, 61 (82.4%) were successfully eradicated. The mean duration of follow-up was 27.2±18.7 months. H. pylori colonization, neutrophil infiltration, mononuclear cell infiltration and intestinal metaplasia decreased after eradication (all p<0.05). For all the patients, metachronous gastric cancer showed a decrease in the eradicated group, but this did not reach statistical significance (odds ratio: 0.36, 95% CI: 0.08-1.70, p=0.189). However, when restricted to those who were followed-up for more than 18 months, metachronous gastric cancer was significantly decreased in the eradicated group (odds ratio: 0.108, 95% CI: 0.016-0.726, p=0.035). Conclusions: Eradication of H. pylori decreased precancerous lesions, and when following-up for more than 18 months, eradication also reduced metachronous gastric cancer.