Characteristics and prognosis of gastric cancer according to Helicobacter pylori.

Abstract

14 Background: Different features of gastric cancer according to Helicobacter pylori(Hp) infection is still under debate. The aim of this study was to compare clinical, pathologic characteristics and prognosis of gastric cancer between Hp-positive (HpP) and Hp-negative (HpN) gastric cancer. Methods: Patients diagnosed as gastric cancer in Seoul National University Bundang hospital from June 2003 to December 2010 were reviewed. Status of Hp was evaluated by histology and rapid urease test (RUT). Patients who had positive histology and/or positive RUT were classified as HpP. Patients who had atrophic gastritis and/or intestinal metaplasia from histology were also classified as HpP. Patients who had both negative histology and RUT were defined as HpN. Results: The number of patients with HpP and HpN were 852 (62.6%) and 509 (37.4%), respectively. Antral location was more common in gastric cancer with HpP than in those with HpN (51.8% vs 44.9%, P = 0.003). Stage of gastric cancer was higher in patients with HpN than in patients with HpP (stage IV 17.9% vs 9.6%, P < 0.001). Age, sex of patients and Lauren classification of gastric cancer was not different according to Hp status. Recurrence and mortality was significantly higher in patients with HpN gastric cancer than those in HpP gastric cancer (P = 0.002 and P= 0.001). Conclusions: Gastric cancers have different clinical and pathologic features according to the Hp status. Patients with HpN gastric cancers have poorer prognosis than those with HpC or HpP gastric cancers.