Helicobacter pylori eradication for gastric cancer prevention

Abstract

Gastric cancer is the second most common fatal malignancy in the world. Its incidence is high in East Asia. Helicobacter pylori infection is an important factor in the pathogenesis of gastric cancer. Epidemiological studies have established a strong causal relationship between H. pylori infection and gastric cancer. H. pylori eradication is therefore likely to be one of the most promising approaches to gastric cancer prevention. Animal studies have shown that eradication of H. pylori infection, especially at the early stage, is effective in preventing H. pylori-related gastric carcinogenesis. However, the available data from human studies show that H. pylori eradication does not completely prevent gastric cancer and that it might be useful only in patients without atrophic gastritis or intestinal metaplasia at baseline. Longer follow-up and additional studies are needed to clarify this issue.

Expression of bile acid receptor TGR5 in gastric adenocarcinoma

“…Helicobacter pylori infection is known to be the strongest risk factor for the development of this neoplasm (20). However, H. pylori eradication does not completely prevent gastric cancer, and it might be useful only in patients without atrophic gastritis or intestinal metaplasia at baseline (4). Duodenal reflux through the pylorus has been reported to induce gastric adenocarcinoma in rats, suggesting that duodenal juice, including bile acids, may be a risk factor for development of gastric adenocarcinoma (15).…”

Factors Affecting Physicians’ Practices Related to <i>Helicobacter pylori</i> Infection: Effect of Experience and Mode of Practice

“…Appropriate testing and treatment of H. pylori infection have been shown to prevent the recurrence of peptic ulcer [4, 5] and decrease the risk of gastric cancer in high-risk populations [6,7,8]. Guidelines on the management of H. pylori infection in different clinical situations have been published and are being periodically revised[ 3,9,10,11].…”

Molecular Epidemiology of Helicobacter pylori in Brazilian Patients with Early Gastric Cancer and a Review to Understand the Prognosis of the Disease

“…Several studies have indicated that H. pylori screening and eradication is a costeffective strategy for the prevention of gastric cancer in middle-aged adults, even if the treatment prevents only 20%-30% of H. pylori-associated cancers, and that the strategy is particularly beneficial in high-risk populations and in the long term [77,104,105,106], although the feasibility, safety and appropriated timing of this strategy for cancer prevention in the general population remains to be determined [77].…”

“…Both diffuse and intestinal types are associated with H. pylori infection, which plays an initiating role in the pathogenesis of gastric cancer by changing many important factors, including antioxidant agents, reactive oxygen metabolites, and the balance between epithelial cell proliferation and apoptosis [77]. H. pylori infection induces cell apoptosis, stimulates cell proliferation in the gastric epithelium, and causes alterations or mutations of apoptosis/ proliferation-related genes [78].…”

“…Animal studies have shown that eradication of H. pylori infection, especially at the early stage, is effective in preventing H. pylori-related gastric carcinogenesis. However, the available data from human studies show that H. pylori eradication does not completely prevent gastric cancer and that it might be useful in patients without atrophic gastritis or intestinal metaplasia at baseline [77].…”