Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis

Abstract

Background The effect of Helicobacter pylori (H. pylori) eradication on gastric cancer (GC) prevention is controversial. Intestinal metaplasia (IM) seems to be a ''point of no return'' in the precancerous cascade. We performed a meta-analysis of randomized controlled trials (RCTs) to illustrate this issue. Materials and Methods The MEDLINE, EMBASE, Cochrane Library were searched for relevant RCTs that were published in any language up to March 2014. By dividing participants into subgroups based on their baseline diagnoses as group \IM (normal, non-atrophic gastritis, atrophic gastritis) and group CIM(intestinal metaplasia, dysplasia), the relative risk (RR) of GC in each study compared treatment group with control group were pooled using Mantel-Haenszel fixed-effect model and publication bias analyses were performed.Results Ten studies from eight RCTs were included in this analysis, for a total of 7,955 participants. H. pylori treatment compared with control significantly reduced the risk of GC, with a pooled RR of 0.64 (95 % CI, 0.48-0.85). Subgroup analysis for patients with non-atrophic gastritis, atrophic gastritis (\IM) yielded a similar results (RR = 0.25, 95 % CI, 0.08-0.81). But this difference was not observed in patients with intestinal metaplasia, dysplasia (CIM) (RR = 0.88; 95 % CI, 0.59-1.31). Conclusions Our results suggested that patients with Intestinal metaplasia or dysplasia could not benefit from the H. pylori treatment on the risk of GC.

Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan

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Diagnosis and Treatment of Helicobacter Pylori Infection: Main Statements of the Maastricht v/Florence Consensus Report (2015)

“…В этих работах было показано, что ЭТ приводит к регрессу атрофи-ческих изменений слизистой, однако не влияет на кишечную метаплазию [7,36,47].…”

Role of age in association between gastric cancer and Helicobacter pylori eradication in cases with intestinal metaplasia and dysplasia

“…I read with interest the recent meta-analysis by Chen et al [1]. They have presented very useful data.…”