Comparison between Resectable Helicobacter pylori-Negative and -Positive Gastric Cancers

Abstract

Background/AimsControversy exists regarding the characteristics of Helicobacter pylori infection-negative gastric cancer (HPIN-GC). The aim of this study was to evaluate clinicopathologic features of HPIN-GC compared to H. pylori infection-positive gastric cancer (HPIP-GC) using a comprehensive analysis that included genetic and environmental factors.MethodsH. pylori infection status of 705 resectable gastric cancer patients was determined by the rapid urease test, testing for anti-H. pylori antibodies, histologic analysis and culture of gastric cancer tissue samples, and history of H. pylori eradication. HPIN-GC was defined as gastric cancer that was negative for H. pylori infection based on all five methods and that had no evidence of atrophy in histology or serology.ResultsThe prevalence of HPIN-GC was 4% (28/705). No significant differences with respect to age, sex, smoking, drinking, family history of gastric cancer or obesity were observed between the two groups. HPIN-GC tumors were marginally more likely to involve the cardia (14.3% for HPIN-GC vs 5.3% for HPIP-GC, p=0.068). The Lauren classification, histology, and TNM stage did not differ according to H. pylori infection status. Microsatellite instability was not different between the two groups, but p53 overexpression in HPIN-GC was marginally higher than in HPIP-GC (56.0% for HPIN-GC vs 37.0% for HPIP-GC, p=0.055).ConclusionsThe prevalence of HPIN-GC was extremely low, and its clinicopathologic characteristics were similar to HPIP-GC.

Eradication of <b><i>Helicobacter pylori</i></b> Induces Immediate Regressive Changes in Early Gastric Adenocarcinomas

“…No significant differences were noted in the histopathological types of the eradicated and non-eradicated cancers, and this result was consistent with previous reports [11, 14, 22, 25, 26]. Additionally, independently of the eradication status, a gastrointestinal phenotype was observed more often than the gastric, intestinal, and null phenotypes in our analysis.…”

Association between Helicobacter pylori and Gastric Cancers

“…Therefore, we conclude that the study by Kim et al 2. should be rearranged to account for the above-mentioned suggestions before interpretations are provided.…”

“…Therefore, we suggest that patients with gastric cancer should be categorized into three groups: patients with current, past, and negative H. pylori infection. Therefore, Kim et al 2. could also evaluate the effect of H. pylori eradication on gastric cancer in their study.…”

“…Second, Kim et al 2 have defined current H. pylori infections according to the results from at least one of the following tests: histological, rapid urease, and culture. However, the American College of Gastroenterology guidelines for the management of H. pylori infection recommends using at least two different tests to diagnose of H. pylori except culture 4.…”

“…Finally, infection with CagA-positive H. pylori strain has been associated with a higher risk of developing gastric cancer because it is a more virulent strain 1. However, Kim et al 2. did not assess genetic analyses for H. pylori .…”