Helicobacter pylori and Molecular Markers as Prognostic Indicators for Gastric Cancer in Korea

Abstract

Background: The prognosis of H. pylori infection-negative gastric cancer (HPIN-GC) has been rarely investigated. Applying a strict definition of H. pylori status, the prognosis and molecular prognostic markers in HPIN-GC were evaluated. Methods: A combination of multiple methods was carried out to strictly evaluate H. pylori infection in gastric cancer (GC) patients between June 2003 and October 2012 at Seoul National University Bundang Hospital. H. pylori infection was defined as negative if histology, a rapid urease test, culturing, serology and history of H. pylori eradication were all negative. Patients with severe gastric atrophy by the serum pepsinogen test or histology were assumed to have had a previous H. pylori infection. Epstein-Barr virus (EBV) in situ hybridization, PCR-based microsatellite instability (MSI) testing, and p53 immunohistochemistry were performed. Results: Compared to 509 H. pylori infection-positive gastric cancer (HPIN-PC) patients, 24 HPIN-GC patients showed a significantly higher frequency of cardia location (P=0.013), and the depth of invasion in HPIN-GC was more advanced, although there was no statistical significance (pT3-pT4, 37.5% for HPIN-GC vs. 28.5% for HPIP-GC, P=0.341). In multivariate analysis, depth of invasion and lymph node metastasis were identified as the most important prognostic factors for relapse-free survival and overall survival (P＜0.001). However, the status of H. pylori infection was not an independent prognostic factor for relapse-free survival and overall survival. The positivity of EBV in both groups was low, and the survivals according to MSI and p53 status in HPIN-GC patients were not significantly different. Conclusions:The status of H. pylori infection was not a prognostic factor for survival in GC patients when applying the strict definition of H. pylori infection. The prognostic implication of MSI and p53 on survival in HPIN-GC patients was not clear. (J Cancer Prev 2014;19:56 -67)

Endoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia

“…Therefore, the incidence of gastric cancer recurrence after H. pylori eradication remains to be fully characterized. Although molecular factors predictive of gastric cancer are useful 19 20 , simpler methods are believed to be desirable. Atrophy and IM have been recognized as risk factors for gastric cancer following H. pylori eradication 10 11 21 22 23 .…”

The Role of Cathelicidin LL-37 in Cancer Development

“…Among them, Helicobacter pylori plays a key role in stomach carcinogenesis, as evidenced by epidemiological and clinical studies (Kim et al 2014 ; Wu et al 2010b ). However, the newest survival analysis conducted in 2014 revealed that H. pylori infection as a prognostic factor for gastric cancer patient is not clear (Kim et al 2014 ). There is an intimate relationship between cancer and inflammation, and H. pylori infection induces inflammation and intensifies secretion of pro-inflammatory cytokines.…”

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

“…The prevalence of H. pylori infection-negative gastric cancer (HPIN-GC) is considered very low, 13.8% in Italy 6 and 24.6% in Germany 5 and 0.66% to 10.6% in Korea 7 , 11 , 12 and Japan. 8 – 10 Previous studies have shown that HPIN-GC has known to have different clinicopathologic characteristics and prognosis compared to H. pylori -positive gastric cancer (HPIP-GC), 5 – 7 but those studies have not shown the consistent results because of the difference in the definition of H. pylori infection status.…”