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http://www.umin.ac.jp/ctr/index.htm (ID: UMIN-000002536).

We conducted a case‐control study to evaluate the effect of Helicobacter pylori (HP) infection on the risk of gastric cancer in Tokyo, Japan. The sera at the time of diagnosis from 282 gastric cancer cases and 767 sex‐ and age‐matched cancer‐free controls were tested for the presence of anti‐HP IgG antibody (HM‐CAP ELISA kit) and serum pepsinogen (PG) level (PG I and PG II Riabead). No significant association was observed in all sets [matched odds ratio (OR)=1.04, 95% confidence interval: 0.73–1.49]. In subgroup analyses, however, an association was suggested in females [OR=1.57], a younger population (<50 years) [OR=1.86], early cancer [OR=1.53] and small cancer (<40 mm) [OR=1.55]. Furthermore, we observed a tendency for odds ratios to decrease with an increase in age or cancer growth (depth of tumor invasion and tumor size). Considering that the spontaneous disappearance of HP due to extended mucosal atrophy may lead to these decreasing odds ratios, we applied the conditional logistic model adjusted for the PG I/II ratio as a measure of atrophic gastritis. This analysis showed a positive association with HP infection in all sets [OR=1.69; 1.01–2.81], distal cancer [OR=1.88; 1.07–3.31] and intestinal‐type cancer [OR=3.76; 1.39–10.18]. We concluded that the risk of cancer associated with HP infection may be underestimated in studies with cross‐sectional exposure because of spontaneous disappearance of HP due to extended mucosal atrophy.

Background and Aims Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is used for the histopathological diagnosis of any type of gastrointestinal disease. Few adverse events are experienced with this procedure; however, the actual rate of adverse events remains unclear. This study aimed to clarify the current status of cases that experienced adverse events related to the EUS‐FNA procedure used for histopathologic diagnoses. Methods A retrospective analysis of cases with EUS‐FNA‐related adverse events in Japanese tertiary centers was conducted by assessing the following clinical data: basic case information, FNA technique, type of procedural adverse events, and prognosis. Results Of the 13,566 EUS‐FNA cases overall, the total number of cases in which adverse events related to EUS‐FNA occurred was 234. The incidence of EUS‐FNA‐related adverse events was ~1.7%. Bleeding and pancreatitis cases accounted for ~49.1% and 26.5% of all adverse events, respectively. Bleeding was the most common adverse event with only seven cases requiring blood transfusion. In cases with neuroendocrine tumors, pancreatitis was the most frequent adverse event. Needle tract seeding because of EUS‐FNA was observed during the follow‐up period in only ~0.1% of cases with pancreatic cancer. There was no mortality because of adverse events caused by EUS‐FNA. Conclusions This study revealed that the adverse events‐related EUS‐FNA for histopathologic diagnoses were not severe conditions, and had low incidence.

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