Abstract
OBJECTIVE:Esophageal squamous cell carcinoma is one of the most common esophageal diseases in the developing world, but the relationship between esophageal squamous cell carcinoma and Helicobacter pylori infection remains a neglected topic. The primary objective of this study was to determine the association between Helicobacter pylori infection and esophageal squamous cell carcinoma. A second purpose was to determine the incidence and factors associated with Helicobacter pylori infection following esophagectomy.METHOD:The microorganism was identified by testing the gastric biopsy materials from 95 esophageal squamous cell carcinoma patients (66 females; 39 were esophagectomized) for urease activity in a medium containing urea and a power of hydrogen detection reagent and comparing the results with those from a healthy population. Differences in patient characteristics were assessed with chi-square tests and t-tests for categorical and continuous factors, respectively.RESULTS:The patients with esophageal squamous cell carcinoma had a significantly lower prevalence of Helicobacter pylori compared with the healthy population (p<0.001). The naive and esophagectomized patients, in contrast, showed no significant differences in Helicobacter pylori infection (p>0.005). Patients with esophageal squamous cell carcinoma showed a significant association between leukocytosis and hypoglobulinemia and the presence of Helicobacter pylori infection (p=0.023 and p=0.045, respectively).CONCLUSION:These results suggest that Helicobacter pylori is not an etiological factor in patients with esophageal squamous cell carcinoma. We found a statistically significant negative correlation between esophageal squamous cell cancer and Helicobacter pylori infection. These findings may guide new strategies for esophageal squamous cell carcinoma therapy.
Highlights
Esophageal squamous cell carcinoma (ESCC), one of the most aggressive digestive system tumors, is associated with numerous factors, including advanced age, achalasia, Plummer-Vinson syndrome, low socioeconomic status, high-starch diets lacking in fruits and vegetables, alcohol abuse, tobacco use, previous head and neck squamous cell carcinoma, and radiation therapy [1]
Recent studies have demonstrated a high frequency of Helicobacter pylori (HP) infection in gastric cancer patients, suggesting that presence of HP may function as a driver of the events contributing to oncogenesis in gastric adenocarcinomas [5,6]
We found a significantly lower rate of HP in patients with ESCC compared with the dyspeptic subjects, whereas no statistically significant difference was detected between the naive ESCC patients and their esophagectomized counterparts (p40.005)
Summary
Esophageal squamous cell carcinoma is one of the most common esophageal diseases in the developing world, but the relationship between esophageal squamous cell carcinoma and Helicobacter pylori infection remains a neglected topic. The primary objective of this study was to determine the association between Helicobacter pylori infection and esophageal squamous cell carcinoma. A second purpose was to determine the incidence and factors associated with Helicobacter pylori infection following esophagectomy. The naive and esophagectomized patients, in contrast, showed no significant differences in Helicobacter pylori infection (p40.005). Patients with esophageal squamous cell carcinoma showed a significant association between leukocytosis and hypoglobulinemia and the presence of Helicobacter pylori infection (p=0.023 and p=0.045, respectively). We found a statistically significant negative correlation between esophageal squamous cell cancer and Helicobacter pylori infection. These findings may guide new strategies for esophageal squamous cell carcinoma therapy. Received for publication on July 12, 2016; First review completed on October 10, 2016; Accepted for publication on December 19, 2016
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