Exploration of endoscopic findings and risk factors of early gastric cancer after eradication of Helicobacter pylori

Abstract Objective To investigate the effect of Helicobacter pylori (H. pylori) eradication on the prognosis of postoperative early gastric cancer (EGC). Methods This is a retrospective study based on data from 6 hospitals. We identified 429 patients with EGC who underwent curative gastrectomy from January 2010 to December 2016. All of the patients were tested for H. pylori. Patients were divided into two groups, the successful H. pylori eradication group (group A, 268 patients) and the non-H. pylori eradication group (group B, 161 patients), for calculating the disease-free survival (DFS) and overall survival (OS) of each group. Result Positive node metastasis (hazard ratio (HR), 3.13; 95% confidence interval (CI), 1.84–5.32; P < 0.001), undifferentiated type (HR, 2.54; 95% CI, 1.51–4.28; P < 0.001), and non-H. pylori eradication (HR, 1.73; 95% CI, 1.08–2.77; P = 0.023) were statistically significantly independent risk factors of recurrence. Patient’s age ≥60 years old (HR, 3.32; 95% CI, 2.00–5.53; P < 0.001), positive node metastasis (HR, 3.71; 95% CI, 2.25–6.12; P < 0.001), undifferentiated type (HR, 3.06; 95% CI, 1.79–5.23; P < 0.001), and non-H. pylori eradication (HR, 1.83; 95% CI, 1.11–3.02; P = 0.018) were statistically significantly independent risk factors of overall survival. Conclusion H. pylori eradication treatment could prevent the recurrence of postoperative EGC to prolong the overall survival of patients with EGC.

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Sa1228 LINKED COLOR IMAGING IDENTIFIES NOVEL RISK FACTORS OF EARLY GASTRIC CANCER DETECTED AFTER SUCCESSFUL HELICOBACTER PYLORI ERADICATION: ROLE OF MAP-LIKE REDNESS AND PATCHY REDNESS

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.267 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB174

Author(s):

Atsushi Majima ◽

Osamu Dohi ◽

Yuji Naito ◽

Kazuyuki Ogita ◽

Shun Takayama ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Helicobacter Pylori ◽

Early Gastric Cancer ◽

Color Imaging ◽

Helicobacter Pylori Eradication ◽

Novel Risk Factors ◽

Linked Color Imaging

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Detection of Early Gastric Cancer after Helicobacter pylori Eradication

Digestion ◽

10.1159/000519838 ◽

2021 ◽

pp. 1-8

Author(s):

Satoki Shichijo ◽

Noriya Uedo ◽

Tomoki Michida

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Helicobacter Pylori ◽

Early Gastric Cancer ◽

Eradication Therapy ◽

Low Grade ◽

Gastric Cancers ◽

Risk Patients ◽

Linked Color Imaging ◽

H Pylori

Background: Based on evidence that Helicobacter pylori eradication reduces the development of gastric cancer and other diseases such as peptic ulcer, eradication therapy has prevailed. However, gastric cancer can develop even after successful eradication. Summary: In this review article, we searched for studies that identified the characteristics of primary and metachronous gastric cancers after H. pylori eradication, the risk factors for the development of these cancers after successful H. pylori eradication, and whether image-enhanced endoscopy is useful for diagnosing gastric cancer after eradication. A gastritis-like appearance is seen as a characteristic endoscopic finding, which corresponds to an epithelium with low-grade atypia – also known as nonneoplastic epithelium – covering the surface of the cancerous glands. This finding may make endoscopic detection of early gastric cancer difficult after H. pylori eradication. Similar risk factors, such as the male sex, endoscopic atrophy, histologic intestinal metaplasia, and late eradication, have been reported as predictors for the development of both primary and metachronous gastric cancers. Image-enhanced endoscopy, such as linked color imaging, may be useful for the detection and risk stratification of gastric cancer after eradication. Key Messages: Based on these findings, we believe that effective surveillance of high-risk patients leads to early detection of gastric cancer in the era of H. pylori eradication.

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