Helicobacter pylori‐negative gastric cancer in Guatemala: Incidence, clinical characteristics, treatment modalities, and outcomes.

318 Background: Gastric cancer (GC) in Guatemala is the second most common cancer diagnosis and the second leading cause of cancer death in both sexes. It is difficult to determine the exact incidence rate of H. pylori infection‐negative gastric cancer (HPIN‐GC) because H. pylori detection rates decrease with the progression of gastric atrophy and intestinal metaplasia. The aim of this study was to evaluate the incidence, clinicopathologic characteristics, treatment modalities and outcomes. Methods: A retrospective review of the medical records of 210 pts with histological diagnosis of gastric cancer evaluated at the General Hospital of Diseases from the Guatemalan Social Security Institute (IGSS) from January 2010 to December 2018. Helicobacter pylori infection status was evaluated by histology, a rapid urease test Current H. pylori infection was defined as positive results from histology. Overall survival was estimated by Kaplan Meier method and compared by Log-rank test. P value < 0.05 was considered significant. Results: The rate of HPIN‐GC occurrence was 36% (n = 76). Sex, age, location of the tumor, Lauren’s classification and treatment modalities were not different according to H. pylori infection status. However, HPIN‐GC had a more advanced pT classification (T3/T4; 58 vs 28%, p=.019) and a more advanced stage (more than stage I; 64 vs 44%, p=.033) than H. pylori‐positive gastric cancer. Treatment modalities: 22% gastrectomy, 24% palliative care, 54% systemic chemotherapy at any time of disease course, 33% initial palliative surgery (derivative o gastrectomy), gastrectomy at any time in 16% (n 7). For those patients who received systemic chemotherapy (n 113) objective response rate was 38% and disease control rate 66%.Median OS was 26 months: 47 m for localized, 18 for locally advanced, and 8 m for advanced disease ( P=.0001). Only 17% of patients received second line chemotherapy and 4% a third line. Conclusions: At least 36% cases of gastric cancer were H. pylori negative. HPIN‐GC looks like to have a poorer prognosis than H. pylori‐positive cases. Chemotherapy can be offered to less than a half of patients. the earliest stages are associated with better survival.

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Virulence genes of Helicobacter pylori in the Dominican Republic

Journal of Medical Microbiology ◽

10.1099/jmm.0.075275-0 ◽

2014 ◽

Vol 63 (9) ◽

pp. 1189-1196 ◽

Cited By ~ 18

Author(s):

Seiji Shiota ◽

Modesto Cruz ◽

José A. Jiménez Abreu ◽

Takahiro Mitsui ◽

Hideo Terao ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Dominican Republic ◽

Infection Rate ◽

Rapid Urease Test ◽

Test Culture ◽

Urease Test ◽

The Status ◽

H Pylori

Although the incidence of gastric cancer in the Dominican Republic is not high, the disease remains a significant health problem. We first conducted a detailed analysis of Helicobacter pylori status in the Dominican Republic. In total, 158 patients (103 females and 55 males; mean age 47.1±16.2 years) were recruited. The status of H. pylori infection was determined based on four tests: rapid urease test, culture test, histological test and immunohistochemistry. The status of cagA and vacA genotypes in H. pylori was examined using PCR and gene sequencing. The overall prevalence of H. pylori infection was 58.9 %. No relationship was found between the H. pylori infection rate and the age range of 17–91 years. Even in the youngest group (patients aged <29 years), the H. pylori infection rate was 62.5 %. Peptic ulcer was found in 23 patients and gastric cancer was found in one patient. The H. pylori infection rate in patients with peptic ulcer was significantly higher than that in patients with gastritis (82.6 versus 54.5 %, P<0.01). The cagA-positive/vacA s1m1 genotype was the most prevalent (43/64, 67.2 %). Compared with H. pylori-negative patients, H. pylori-positive patients showed more severe gastritis. Furthermore, the presence of cagA was related to the presence of more severe gastritis. All CagA-positive strains had Western-type CagA. In conclusion, we found that H. pylori infection is a risk factor for peptic ulcer in the Dominican Republic. Patients with cagA-positive H. pylori could be at higher risk for severe inflammation and atrophy.

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GENDER, AGE, ENDOSCOPIC FINDINGS, UREASE AND HELICOBACTER PYLORI: ALL UNCORRELATED WITHIN A SAMPLE OF A HIGH GASTRIC CANCER PREVALENCE POPULATION IN AMAZON

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201900000-50 ◽

2019 ◽

Vol 56 (3) ◽

pp. 264-269

Author(s):

Ariney Costa de MIRANDA ◽

Cássio CALDATO ◽

Mira Nabil SAID ◽

Caio de Souza LEVY ◽

Claudio Eduardo Corrêa TEIXEIRA ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Cross Sectional Study ◽

Upper Gastrointestinal Endoscopy ◽

Histopathological Analysis ◽

Rapid Urease Test ◽

Cross Sectional ◽

Cancer Prevalence ◽

Urease Test ◽

H Pylori

ABSTRACT BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.

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Prevalence of Helicobacter pylori infection, its correlation with gastroduodenal diseases and the incidence of gastric cancer in Nepal

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v2i2.8777 ◽

2013 ◽

Vol 2 (2) ◽

pp. 52-60 ◽

Cited By ~ 1

Author(s):

Umid Kumar Shrestha ◽

Arnab Ghosh ◽

Vijay M Alurkar ◽

Suresh C Kohli ◽

Subash Sapkota

Keyword(s):

Gastric Cancer ◽

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Gastric Ulcer ◽

Cancer Incidence ◽

Gastric Polyp ◽

Rapid Urease Test ◽

Asian Countries ◽

Urease Test ◽

H Pylori

Background and aims: The Helicobacter pylori (H. pylori) prevalence in Asian countries is highly variable, with higher seroprevalence shown in the previous studies of developing Asian countries. We aimed to determine the current H. pylori prevalence, correlate with gastroduodenal diseases and study gastric cancer incidence in Nepal. Methods: Among 3357 patients referred for endoscopy, 2820 eligible patients underwent upper gastrointestinal endoscopy with biopsy; H. pylori was considered positive when either of Rapid Urease Test (RUT) or histopathology showed positive result. Results: The H. pylori prevalence was 29.4% in overall distribution, 41.1% in gastritis and or duodenitis, 69.5% in gastric ulcer, 84.7% in duodenal ulcer, 20.8% in gastric polyp and 11.5% in gastric cancer. The H. pylori infection was significantly associated with gastritis and or duodenitis [P<0.001; Odds Ratio (OR) 1.53, 95% Confidence Interval (CI) 1.47-1.59], gastric ulcer (P<0.001; OR 18.62, 95% CI 12.40-27.81), duodenal ulcer (P<0.001; OR 48.89, 95% CI 25.23- 94.75), gastric polyp (P=0.001; OR 7.66, 95% CI 3.18-18.44) and gastric cancer (P=0.005; OR 3.78, 95% CI 1.82-7.86). The age-standardized (world) annual rate of gastric cancer in Kaski district of Nepal was 3.3 per 100,000. Conclusions: The H. pylori prevalence in Nepal was lower than that shown in the previous studies of developing Asian countries, but was significantly high in gastritis and or duodenitis, and peptic ulcers. Similarly, the gastric cancer incidence was also low in Nepal and was significantly associated with H. pylori. Further study is needed to establish the association of H. pylori with gastric cancer in Nepal. DOI: http://dx.doi.org/10.3126/jaim.v2i2.8777 Journal of Advances in Internal Medicine 2013;02(02):52-60

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Association of Helicobacter pylori infection with gastric carcinoma

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v35i1.2315 ◽

2009 ◽

Vol 35 (1) ◽

pp. 7-10 ◽

Cited By ~ 2

Author(s):

M.A. Majid ◽

T.I.M.A. Faruq ◽

A.B.M. Bayezid Hossain

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Cross Sectional Study ◽

Body Region ◽

Upper Gastrointestinal Endoscopy ◽

Rapid Urease Test ◽

Cross Sectional ◽

Urease Test ◽

H Pylori ◽

Upper Gastrointestinal

This is a cross-sectional study on 140 gastric neoplasm subjects diagnosed by upper gastrointestinal endoscopy. The commonest site of cancer was the antrum of stomach (52.86%), followed by the antrum and body (32.86%) and only body region (12.14%). Histology revealed adenocarcinoma in all patients. The associations of Helicobacter pylori with gastric cancer were studied by rapid urease test, serology and histology by Giemsa stain. The positivity of H. pylori determined by serology in 70 patients (50%) was significantly higher than those determined by histology 22 patients (15.71%). No significant association between H. pylori infection and gastric cancer was observed.Keywords: Gastric cancer; Helicobacter pylori; InfectionOnline: 20 May 2009DOI: 10.3329/bmrcb.v35i1.2315Bangladesh Med Res Counc Bull 2009; 35: 7-10

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Incidence of Helicobacter Pylori Infections in a group of patients in Erbil City, Kurdistan Region, Iraq and Its Association with Gastritis and Adenocarcinoma

10.21203/rs.3.rs-25271/v1 ◽

2020 ◽

Author(s):

Tavga Hushiar Salim ◽

Salah Tofik Jalal Balaky ◽

Rafal Al-Rawi ◽

Saman Salah eldeen Abdulla ◽

Ahang Hasan Mawlood ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Goodness Of Fit ◽

Diagnostic Tools ◽

Rapid Urease Test ◽

Goodness Of Fit Test ◽

Lymphoid Aggregate ◽

Urease Test ◽

Glandular Atrophy ◽

H Pylori

Abstract Background: Adenocarcinoma is one of the most common causes of Gastric cancer related deaths worldwide. Helicobacter pylori is the causative agent of most cases of gastritis, it can cause chronic active gastritis and known as a risk factor for the development of gastric cancer. This study aimed to assess the prevalence of H. pylori among patients with symptoms of dyspepsia and other gastritis related symptoms and its association with adenocarcinoma.Methods: This study was carried out during the period of January 2018 to October 2019 with a total of 227 patients with gastritis related symptoms. The presence of H. pylori was detected by Rapid Urease Test (RUT) and histo-pathological tests using biopsy specimens. Statistical Analysis was done by using Chi-square test. P < 0.05 was considered to be statistically significant.Results: From the total of 227 patients with gastritis related symptoms, 26 cases (13.61%) were diagnosed with adenocarcinoma. Their ages were between 13 and 90 years with mean of 47.81± 18.23. The result showed that low severity prevalence of H. pylori was highest (111 cases) compared to 17 and 63 cases for high and moderate severity, respectively. Comparison between positive low, moderate, and high H. pylori cases for rapid urease test was highly significant (P<0.000). The results showed no association between H. pylori severity across various age groups and gender. Moreover, goodness of fit test for metaplasia, activity, glandular atrophy, and endoscopic finding across severity status of H. pylori showed highly significant. Four composite categorized groups were initiated based on positive/negative prevalance of H. pylori and adenocarcinoma status. Results revealed statistical significance between combination of H. pylori and adenocarcinoma with inflammation, lymphoid aggregate, metaplasia, activity of neutrophils, glandular atrophy, rapid urease test, and endoscopic findings.Conclusion: Histopathology tests are reliable diagnostic tools for the detection of H. pylori. Data showed that H. pylori was seen more in middle age patients with mucosal lymphoid follicle formation and more than one third of patients with adenocarcinoma. Therefore, screening of these infections is an important strategy for preventing gastric adenocarcinoma.

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Frequency of rdx A Deletion Mutation Conferring Metronidazole Resistance in Helicobacter pylori

10.51429/ejmm29308 ◽

2020 ◽

Vol 29 (3) ◽

pp. 59-64

Author(s):

Hanaa M. El Maghraby ◽

Samar Mohaseb

Keyword(s):

Helicobacter Pylori ◽

Epigastric Pain ◽

Deletion Mutation ◽

Rapid Urease Test ◽

Rrna Gene ◽

University Hospitals ◽

Metronidazole Resistance ◽

Urease Test ◽

Gastric Biopsies ◽

H Pylori

Background: Metronidazole is one of the antimicrobial drugs that can be used in combination with other drugs for eradication of Helicobacter pylori (H. pylori).Unfortunately, metronidazole resistance in H. plori is an increasing health problem which may be attributed to inactivation of many genes as rdx A gene. Objective: To determine the frequency of rdx A deletion mutation in H. pylori detected in infected patients attending at the Gastroenterology Unit, Zagazig University Hospitals. Methodology: Two gastric biopsies were taken from each enrolled patient by endoscopy. H.pylori detection was done by rapid urease test and polymerase chain reaction (PCR) amplification of 16S rRNA gene. Deletion mutation in rdx A gene was detected by conventional PCR. Results: Out of 134 doubled gastric biopsies obtained from 134 patients, 52.2% were positive for H. pylori. Epigastric pain, vomiting and gastritis were significantly associated with detection of H. pylori infection (p˂ 0.05). Deletion mutation of rdx A gene was detected in 28.6% of H. pylori positive specimens obtained from infected patients. Conclusion: Deletion mutation of rdx A gene is a frequent determinant of rdx A inactivation conferring metronidazole resistance among H. pylori.

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Incidence of Gastric Metaplasia and Helicobacter pylori Infection in Duodenal Bulb – With Specific Reference to Patients With Duodenal Ulcers

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.6.17 ◽

1999 ◽

Vol 6 (1) ◽

pp. 17-23 ◽

Cited By ~ 4

Author(s):

Minoru Kawaguchi ◽

Toshihiko Saito

Keyword(s):

Helicobacter Pylori ◽

Duodenal Bulb ◽

Mucosal Injury ◽

Transitional Zone ◽

Specific Reference ◽

Rapid Urease Test ◽

Duodenal Ulcers ◽

Gastric Metaplasia ◽

Urease Test ◽

H Pylori

We determined the incidence of gastric metaplasia in the duodenal bulb of duodenal ulcer patients and the Helicobacter pylori (H. pylori) infection rate at sites with gastric metaplasia. Biopsy of the duodenal bulb showed the presence of gastric metaplasia in 61 of 86 patients (71%) overall and in 18 of 47 patients (38.3%) who had gastrectomy at an early gastric cancer. The histological diagnosis of H. pylori infection showed good agreement (83.3%) with the result of the rapid urease test, indicating that H. pylori occurs in regions with gastric metaplasia. This finding suggests that H. pylori infects gastric metaplasia in the duodenal bulb, causing mucosal injury, which is then transformed into duodenal ulcers. The exact mechanism by which gastric metaplasia is caused is unknown, but it is believed to occur in the transitional zone in the duodenal mucosa.

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Helicobacter pylori as a risk factor for gastric cancer: the evidence and primary prevention strategy

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2019-47-052 ◽

2019 ◽

Vol 47 (6) ◽

pp. 535-547 ◽

Cited By ~ 1

Author(s):

I. N. Voynovan ◽

Yu. V. Embutnieks ◽

D. V. Mareeva ◽

S. V. Kolbasnikov ◽

D. S. Bordin

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Risk Factor ◽

Primary Prevention ◽

Russian Federation ◽

Diagnostic Methods ◽

Rapid Urease Test ◽

First Line ◽

Urease Test ◽

The Russian Federation

Russia is a country with a high prevalence of Helicobacter pylori (HP) infection, a high incidence of gastric cancer, and its late diagnosis. HР infection has been recognized as the leading manageable risk factor for gastric cancer. Accurate diagnostic tests must be used to identify and control the effectiveness of HP eradication, and effective schemes must be implemented for HP eradication. The aim of this article was to analyze the latest consensus documents, systematic reviews and meta-analyzes that reflected the role of HP as a risk factor for the development of gastric cancer, as well as measures for the risk reduction. We describe in detail the diagnostic methods for HP infection, provide data on their use in the Russian Federation, and analyze the efficacy of eradication regimens. In all HPinfected individuals, HP leads to chronic inflammation in the gastric mucosa and launches a precancerous cascade (Correa's cascade). The risk of gastric cancer increases with severe atrophy, intestinal metaplasia and dysplasia. Primary prevention of gastric cancer is most effective if the eradication is performed before atrophic gastritis develops. The available consensus documents underline the importance of HP infection identification by accurate diagnostics at this stage of chronic gastritis. In Russia, the primary HP diagnosis is based on histology (37.7%), rapid urease test (29.2%), and serology (29.7%). HP stool antigen test (31.3%), 13C-urea breath test (23.4%) and the histological method (23.3%) are most often used to control eradication. Currently, the first line of eradication therapy is recommended as triple therapy with clarithromycin prescribed for 14 days. It is recommended to use double dose of proton pump inhibitors and bismuth to increase the effectiveness of this scheme. A 14-days triple regimen enhanced by bismuth has been recommended as the first-line therapy in the Russian Federation.

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Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study

Vojnosanitetski pregled ◽

10.2298/vsp150415127g ◽

2016 ◽

Vol 73 (11) ◽

pp. 1044-1049 ◽

Cited By ~ 3

Author(s):

Sasa Grgov ◽

Tomislav Tasic ◽

Biljana Radovanovic-Dinic ◽

Daniela Benedeto-Stojanov

Keyword(s):

Helicobacter Pylori ◽

Randomized Study ◽

Eradication Therapy ◽

Saccharomyces Boulardii ◽

Rapid Urease Test ◽

Group I ◽

Urease Test ◽

Probiotic Strains ◽

The Difference ◽

H Pylori

Background/Aim. Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy. Methods. This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 ? 30 mg half an hour before the meal, amoxicillin 2 ? 1.000 mg per 12 hours and clarithromycin 2 ? 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori. Results. Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant. Conclusion. Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics.

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Antibiotic resistance of Helicobacter pylori in the European part of the Russian Federation: first results

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.08.000761 ◽

2020 ◽

Vol 92 (8) ◽

pp. 24-28

Author(s):

I. V. Maev ◽

D. N. Andreev ◽

V. M. Govorun ◽

E. N. Ilina ◽

Yu. A. Kucheryavyy ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Russian Federation ◽

European Part ◽

Diffusion Method ◽

Rapid Urease Test ◽

Urease Test ◽

First Results ◽

The Russian Federation ◽

H Pylori

Aim. Determine the primary antibiotic resistance of Helicobacter pylori (H. pylori) strains isolated from patients living in the European part of the Russian Federation. Materials and methods. As part of a clinical laboratory study, from 2015 to 2018, 27 gastrobiopsy samples obtained from H. pylori-infected patients were analyzed. H. pylori infection was verified using a rapid urease test or a 13C-urea breath test. The values of the minimum inhibitory concentration (MIC) of antibiotics were determined by the diffusion method using E-test strips (BioMerieux, France) according to the recommendations of the manufacturer. The sensitivity of the isolates was determined for 6 antibacterial drugs (amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, rifampicin). Results. According to the data obtained, resistance to amoxicillin was 0%, clarithromycin 11.1%, metronidazole 59.3%, levofloxacin 3.7%, tetracycline 0%, and rifampicin 14.8%. Dual resistance to clarithromycin and metronidazole was recorded in two isolates (7.4%). Conclusion. Thus, the first results of the evaluation of H. pylori antibiotic resistance in the European part of the Russian Federation indicate a low resistance of the microorganism to clarithromycin and quite high to metronidazole.

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