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

2019 ◽  
Vol 47 (6) ◽  
pp. 535-547 ◽  
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.

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

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.

scholarly journals Virulence genes of Helicobacter pylori in the Dominican Republic

2014 ◽  
Vol 63 (9) ◽  
pp. 1189-1196 ◽  
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.

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

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.

Increased Incidence of Helicobacter pylori in Gastric Cancer, as Shown by the Rapid Urease Test

1993 ◽  
pp. 229-231
Author(s):  
D. Boixeda ◽  
A. L. San Roman ◽  
C. Martin de Argila ◽  
R. Cantón ◽  
C. Redondo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Rapid Urease Test ◽  
Urease Test

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

scholarly journals Bismuth Containing Quadruple Therapy versus Tailored Therapy as first-line treatments for Helicobacter pylori infection in a high clarithromycin resistance area

2019 ◽  
Author(s):  
Byoung Wook Bang ◽  
Jong Beom Shin ◽  
Eun Jung Ko ◽  
Kye Sook Kwon ◽  
Yong Woon Shin ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Cost Effective ◽  
Medical Costs ◽  
Rapid Urease Test ◽  
First Line ◽  
Tailored Therapy ◽  
Quadruple Therapy ◽  
Clarithromycin Resistance ◽  
Urease Test ◽  
H Pylori

Abstract Background Increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) in Korea, and bismuth containing quadruple therapy (BQT) and tailored therapy (TT) have been proposed as alternative regimens. The aim of this study was to compare the eradication rates of BQT and TT as first-line H. pylori eradication therapies. Methods H. pylori infection was diagnosed using the rapid urease test or dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) during endoscopy. Patients positive for H. pylori were divided into two groups; those tested using the rapid urease test received empirical BQT (the BQT group) whereas those tested by DPO-PCR received TT (the TT group). Eradication rates, adverse events, and overall medical costs, which included diagnostic test and eradication regimen costs, were compared. Results Three hundred and sixty patients were included in the study (TT group 178, BQT group 182). The modified intention-to-treat eradication rates of BQT and TT were 88.2% (142/161) and 80.3% (118/147), respectively (p=0.055), and corresponding eradication rates in the per-protocol population were 88.8% (142/160) and 81.4% (118/145) (p=0.07). Compliance and adverse event rates were similar in the two groups. Average medical costs were $ 90.3 per patient in the TT group and $ 75.5 in the BQT group (p=0.000). Conclusions Empirical BQT and tailored therapy were similar in terms of H. pylori eradication rate, safety, and tolerability, but BQT was more cost-effective.

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

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 318-318
Author(s):  
Rixci Ramirez ◽  
Daniel Estuardo Rosales Lopez ◽  
Francisco Javier Godinez ◽  
Carolina Camey ◽  
Marisol Gramajo
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Systemic Chemotherapy ◽  
Objective Response ◽  
Locally Advanced ◽  
Treatment Modalities ◽  
Rapid Urease Test ◽  
Infection Status ◽  
Urease Test ◽  
H Pylori

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.

scholarly journals A REVIEW OF HELICOBACTER PYLORI INFECTION DISEASES, ANTIBIOTIC RESISTANCE AND DIAGNOSIS

2018 ◽  
Vol 11 (12) ◽  
pp. 566
Author(s):  
Bolai Paul ◽  
Senthil Adimoolam ◽  
Mohd Javed Qureshi ◽  
Nahlah Elkudssiah Ismail
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Developed Countries ◽  
Epidemiologic Studies ◽  
Diagnostic Methods ◽  
Gastric Ulcers ◽  
Rapid Urease Test ◽  
Stool Antigen Test ◽  
Urease Test ◽  
H Pylori

Objective: The aim of the study was designed to assess the mechanisms of antibiotic resistance in Helicobacter pylori, affecting disease by this infection and diagnostic methods which are used to detect H. pylori.Methods: A wide literature search was performed using PubMed, Medline, Cinahl, Embase, Educational Resources Information Center, PsycINFO, Google Scholar, Scopus, and Web of Science, and review of appropriate epidemiologic studies conducted from 1995 to 2017 for studies fully published investigating a contribution between H. pylori infection, antibiotic resistance, and diagnosis of H. pylori infection.Results: H. pylori infection is extremely contributed to the main symptoms and death that is currently affecting 50–75% of the people in the world. It is more affected in developing countries compared to developed countries. These infections are regarded to be the most important reasons for gastric cancer, peptic ulcer, chronic gastritis, duodenal ulcer, mucosa-associated lymphoid tissue lymphomas, and gastric adenocarcinoma. About 90–100% of duodenal ulcers and 60–90% of gastric ulcers were associated with H. pylori infections. At present, antibiotic resistance is a growing problem for the eradication of H. pylori infection; it contains metronidazole, amoxicillin, clarithromycin, and levofloxacin resistance. Diagnosis of H. pylori infection is a crucial part for the better treatment of those diseases. Different types of testing method for H. pylori infection are used including invasive (endoscopic image, histology, rapid urease test, and culture) and non-invasive (urea breath test, stool antigen test, and serological).Conclusion: H. pylori antibiotic resistance is the major contributor to the failure of H. pylori treatment. Appropriate diagnostic method selected in detecting H. pylori antibiotic resistance may lead to reduced treatment failures and less antibiotic resistance.

scholarly journals Clarithromycin-based triple therapy for Helicobacter pylori treatment in peptic ulcer patients

2010 ◽  
Vol 4 (11) ◽  
pp. 712-716 ◽  
Author(s):  
Guilherme Felga ◽  
Fernando Marcuz Silva ◽  
Ricardo Correa Barbuti ◽  
Tomas Navarro-Rodriguez ◽  
Schlioma Zaterka ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Risk Factor ◽  
Peptic Ulcer ◽  
Proton Pump Inhibitor ◽  
Adverse Effects ◽  
Proton Pump ◽  
First Line ◽  
Ulcer Disease ◽  
Urease Test ◽  
H Pylori

Introduction: The scheme proton pump inhibitor/amoxicillin/clarithromycin (PPI/AC) is still the first-line treatment for Helicobacter pylori (H. pylori) infections despite evidence suggesting its failure in up to 20% to 30% of patients. Methodology: This study involved 493 patients who were prescribed omeprazole (20 mg twice a day) or another proton pump inhibitor in equivalent dosage, amoxicillin (1 g twice a day), and clarithromycin (500 mg twice a day) for seven days. Efficacy was determined by negative urease test and absence of H. pylori on gastric biopsy samples twelve weeks after the end of treatment. Safety was defined according to the adverse effects reported. Mean age of the patients was (± SD) 48.96 ± 13, and demographic and clinical data were recorded for correlation with treatment outcomes. Results: Out of 493 patients, 316 (64.1%) presented duodenal ulcer, 111 (22.5%) gastric ulcer, and 66 (14.4%) simultaneous gastric and duodenal ulcers. Additionally, 267 (54.2%) patients had at least one risk factor for peptic ulcer disease, smoking being the most common (99 [36.5%]). Successful eradication was achieved in 408 patients. The eradication rates per protocol, and according to the intention to treat, were 88.8% and 82.7%, respectively.  Of 164 (35.5%) patients who presented adverse effects, 100 (61%) reported them as mild and only six (3.7%) patients had to discontinue treatment. Previous use of tobacco and non-steroid anti-inflammatory drugs was the only risk factor for treatment failure (P 0.00). Conclusion: PPI/AC is still a valuable and remarkably tolerable option for first-line H. pylori eradication in Brazil.

scholarly journals Сравнительная оценка эффективности 10-дневных схем эрадикации helicobacter pylori инфекции (тройной и тройной с добавлением висмута трикалия дицитрата)

2019 ◽  
pp. 62-65
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Therapy ◽  
Rapid Urease Test ◽  
Eastern Region ◽  
First Line ◽  
Additional Advantage ◽  
Urease Test ◽  
Group 2 ◽  
Group 1

The article presents the results of a comparative study of the efficacy and tolerability of two 10-day eradication therapy regimens of Helicobacter pylori (HP) infection (triple and triple with the addition of bismuth tripotassium dicitrate (BTD). The study involved 158 patients with HP-associated pathology (dispepsia, erosive and ulcerative lesions of the gastroduodenal mucosa) from 18 to 65 years of age (mean age=44,6±13,5 years): 57 men (36,1 %), 101 women (63,9 %). The diagnostics of HP-infection performed using a rapid urease test (Helpil test St'Petersburg) in the course fibrogastroduodenoscopy (FGDS). The patients were divided randomly into two groups. In the group 1, 75 patients received classical first-line triple therapy: esomeprazole 20 mg twice a day, amoxicillin 1 000 mg twice a day, clarithromycin 500 mg twice a day. In the group 2, 83 patients received treatment using a similar regimen, but with the addition of BTD 240 mg twice a day. The duration of treatment in both groups was 10 days. The effectiveness of the eradication therapy was evaluated after 6-8 weeks of the end of the treatment course by means of qualitative rapid determination of fecal HP antigens using the method of immunochromatography with monoclonal antibodies (Vegal Farmaceutica, Spain). Out of the 75 patients in group 1, 60 (80 %) showed eradication of HP infection was achieved. Out of 83 patients in group 2, the eradication of HP infection was achieved in 76 patients (92,5 %). The difference in the effectiveness of eradication therapy in patients in group 1 and group 2 is statistically significant (p<0,05). Thus, the classical 10-day regimen of triple antihelicobacter therapy is not effective enough and is not recommended for use in clinical practice in Khabarovsk. A 10-day triple therapy with the addition of BTD is highly effective in the Far Eastern region (Khabarovsk) and recommended as a first-line therapy. A significant reduction in the adverse events frequency in the form of bitter taste in the mouth and diarrhea is an additional advantage of the regimen using bismuth tripotassium dicitrate in comparison with the classical regimen of the triple antihelicobacter therapy.

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