Prevalence ofHelicobacter pyloriPositive Non-cardia Gastric Adenocarcinoma Is Low and Decreasing in a US Population

摘要

Background Helicobacter pyloriinfection is an established causal factor for non-cardia gastric cancer.H. pylorinegative gastric cancer prevalence among US patients is unclear. Methods This retrospective cohort study examinedH. pyloriprevalence among consecutive patients with incident non-cardia gastric adenocarcinoma at the Houston VA Hospital (11/2007-10/2018).H. pyloripositivity was defined byH. pylorion histopathology, positive antibody serology, stool antigen, or urea breath testing. We examined for trends inH. pylorinegative gastric cancer based on year of diagnosis. Associations between histopathologic and cancer-related outcomes withH. pyloripositivity were determined using regression models. Results Of 91 patients with gastric adenocarcinoma, most were men (N = 87, 95.6%), black (N = 47, 51.6%), with mean age at diagnosis of 68.0 years (SD 10.8). In addition to gastric cancer biopsy histopathology, 74 patients (81.3%) had >= 1 testing forH. pylori, including antibody serology (n = 34), non-cancer gastric biopsy histopathology (n = 63), or stool antigen (n = 1). The overall prevalence ofH. pyloriinfection was 38.5% and 45.9% among patients with >= 2H. pyloritests. The proportions ofH. pyloripositive gastric cancer decreased from 50.0% (2007-2010) to 43.4% (2011-2014) and 29.3% (2015-2018) (p = 0.096). Active/acute gastritis (adjOR 3.74), atrophic gastritis (adjOR 15.30), and gastric intestinal metaplasia (adjOR 3.65) were associated withH. pyloripositive gastric cancer. Discussion The prevalence ofH. pyloriinfection among patients with non-cardia gastric adenocarcinoma is relatively low (38.5-45.9%) and decreasing over time. This finding suggests there may be other important causal factors apart fromH. pylorifor gastric adenocarcinoma.