Abstract
PurposeThere is insufficient data about the role of eradication of H. pylori after endoscopic resection (ER) for gastric dysplasia. The aim was to investigate the benefit of H. pylori eradication after ER in patients with gastric dysplasia to prevent metachronous gastric neoplasms.Materials and MethodsWe retrospectively reviewed 1872 patients who underwent ER of gastric dysplasia. We excluded patients with a follow-up period of <2 years or who had not undergone tests for active H. pylori infection. A total of 282 patients were enrolled. The patients were categorized into those without active H. pylori infection (H. pylori-negative group, n = 124), those who successfully underwent H. pylori eradication (eradicated group, n = 122), and those who failed or did not undergo H. pylori eradication (persistent group, n = 36).ResultsMetachronous recurrence was diagnosed in 36 patients, including 19 in the H. pylori-negative group, 10 in the eradicated group, and 7 in the persistent group. The cumulative incidence of metachronous recurrence was significantly lower in the H. pylori-eradicated group in comparison with either of the H. pylori-persistent (non-eradicated or failed) groups (p = 0.039). Similarly, the incidence of metachronous recurrence was significantly lower in the H. pylori-eradicated group compared with the H. pylori-negative group (p = 0.041).ConclusionSuccessful H. pylori eradication may reduce the development of metachronous gastric neoplasms after ER in patients with gastric dysplasia.
Highlights
Helicobacter pylori (H. pylori) infection is a group I carcinogen for gastric cancer as defined by the International Agency for Research on Cancer (IARC), a subdivision of the World Health Organization (WHO) [1]
Successful H. pylori eradication may reduce the development of metachronous gastric neoplasms after endoscopic resection (ER) in patients with gastric dysplasia
Some studies have shown that the eradication of H. pylori after ER is helpful to prevent the development of metachronous gastric cancer [12,13,14]; several other studies have failed to show a prophylactic benefit for H. pylori eradication [15,16]
Summary
Helicobacter pylori (H. pylori) infection is a group I carcinogen for gastric cancer as defined by the International Agency for Research on Cancer (IARC), a subdivision of the World Health Organization (WHO) [1]. Correa et al contend that H. pylori infection is closely associated with progression to gastric atrophy, intestinal metaplasia (IM), dysplasia, and cancer [2]. ER can preserve the stomach; metachronous gastric cancer may develop in the stomach remnant after the procedure [10,11]. For this reason, endoscopic surveillance for metachronous gastric neoplasms has become an emerging issue during the follow-up interval after ER. The aim of this study was to determine whether H. pylori eradication prevents the development of metachronous gastric neoplasms in patients with gastric dysplasia following ER
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