Aspirin Use Is Not Associated with the Risk of Metachronous Gastric Cancer in Patients without Helicobacter pylori Infection

Introduction: Helicobacter pylori (H. pylori) eradication can prevent metachronous gastric cancer (MGC) after the performance of an endoscopic resection for early gastric cancer (EGC). However, 50% of infections persist after eradication, and the identification of MGC protective factors is important. The anti-tumor activity of aspirin has been demonstrated, but its efficacy in preventing MGC remains controversial. We evaluated the effect of aspirin on metachronous recurrence in H. pylori-negative patients. Methods: A total of 4351 patients were evaluated between January 2007 and December 2016, and 2151 patients who met the inclusion criteria were analyzed. The primary outcome was the cumulative incidence of MGC after an endoscopic resection for EGC. Results: During a 5-year median follow-up (interquartile range, 3.5–6.2), MGC developed in 176 (7.7%) patients, with a cumulative incidence of 89.4% in aspirin users and 92.7% in non-users; this difference was not statistically significant (p = 0.64). The duration of aspirin uses and the occurrence of MGC in both groups were not significantly different. There was no significant difference between groups when the duration of aspirin use was categorized into ≤1 year (hazard ratio (HR), 0.64; 0.20–2.01, p = 0.45), 1–4 years (HR, 1.35; 0.66–2.76, p = 0.41), and >4 years (HR, 1.17; 0.67–2.03, p = 0.58). Conclusions: Aspirin use was not associated with a lower risk of MGC in H. pylori-negative patients. Further prospective studies are needed.

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Helicobacter pylori Eradication in Patients Undergoing Gastrectomy: Diagnosis and Therapy

The Korean Journal of Helicobacter and Upper Gastrointestinal Research ◽

10.7704/kjhugr.2019.0037 ◽

2020 ◽

Vol 20 (3) ◽

pp. 204-209

Author(s):

Youn I Choi ◽

Jun-Won Chung

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Diagnostic Tests ◽

Remnant Stomach ◽

Optimal Timing ◽

Helicobacter Pylori Eradication ◽

Metachronous Gastric Cancer ◽

H Pylori

The role of Helicobacter pylori (H. pylori) eradication in patients undergoing gastrectomy for gastric cancer is unclear. Although European and Asian guidelines strongly recommend H. pylori eradication in patients who undergo endoscopic resection for early gastric cancer, these guidelines do not specify the tests useful for diagnosing H. pylori infection, the optimal timing and appropriate eradication regimens, and follow-up strategies in patients undergoing gastrectomy for gastric cancer. This review aims to update the guidelines for the diagnosis and management of H. pylori infection in patients undergoing gastrectomy for gastric cancer. We have focused on the following issues: 1) diagnostic tests for H. pylori infection in the remnant stomach, 2) optimal timing and regimen for H. pylori eradication, and 3) role of H. pylori eradication in reducing the risk of metachronous gastric cancer in the remnant stomach.

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Helicobacter pylori Infection following Endoscopic Resection of Early Gastric Cancer

BioMed Research International ◽

10.1155/2019/9824964 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Lan Li ◽

Chaohui Yu

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Precancerous Lesions ◽

Cost Effective ◽

Reduce Healthcare Cost ◽

Metachronous Gastric Cancer ◽

H Pylori ◽

Meta Analyses

The role of Helicobacter pylori (H. pylori) infection in patients following endoscopic resection of early gastric cancer (EGC) remains unclear. This article presents a review of literature published in the past 15 years. H. pylori‐mediated persistent methylation levels are associated with the development of metachronous gastric cancer. The methylation of certain specific genes can be used to identify patients with a high risk of metachronous gastric cancer even after H. pylori eradication. H. pylori eradication after endoscopic resection should be performed as early as possible for eradication success and prevention of metachronous precancerous lesions. Although whether the eradication of H. pylori could prevent the development of metachronous cancer after endoscopic resection is controversial, several meta‐analyses concluded that H. pylori eradication could reduce the incidence of metachronous gastric cancer significantly. In addition, H. pylori eradication in gastric cancer survivors after endoscopic resection could reduce healthcare cost and save lives in a cost‐effective way. Taken together, H. pylori eradication after endoscopic resection of EGC is recommended as prevention for metachronous precancerous lesions and metachronous gastric cancer.

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Statin Use Decreases the Risk of Metachronous Gastric Cancer in Patients without Helicobacter pylori Infection

Cancers ◽

10.3390/cancers13051020 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1020

Author(s):

Tae Jin Kwon ◽

Tae Jun Kim ◽

Hyuk Lee ◽

Yang Won Min ◽

Byung-Hoon Min ◽

...

Keyword(s):

Gastric Cancer ◽

Endoscopic Resection ◽

Cox Regression ◽

Defined Daily Dose ◽

Cox Regression Analysis ◽

Daily Dose ◽

Metachronous Gastric Cancer ◽

H Pylori ◽

Statin Use

Previous studies have shown that statins reduce the risk of gastric cancer; however, their role has not been adequately studied in patients without Helicobacterpylori infection. We aimed to investigate whether statins reduced the risk of metachronous gastric cancer (GC) in H. pylori-negative patients who underwent endoscopic resection for early gastric cancer (EGC). Retrospective data of 2153 patients recruited between January 2007 and December 2016, with no H. pylori infection at baseline, who underwent resection for EGC, were analyzed. Metachronous GC was defined as a newly developed GC at least 1 year after endoscopic resection. Patients who used statins for at least 28 days during the follow-up period were considered as statin users. During a median follow-up of 5 years (interquartile range, 3.5–6.2), metachronous GC developed in 165 (7.6%) patients. In the multivariate Cox regression analysis, statin use was an independent factor associated with GC recurrence (adjusted hazard ratio (HR), 0.46; 95% confidence interval (CI), 0.26–0.82). Moreover, the risk of GC reduced with increasing duration (<3 years: HR 0.40, 95% CI 0.14–1.13; ≥3 years: HR 0.21, 95% CI 0.05–0.90; p trend = 0.011) and the dose of statin (cumulative defined daily dose (cDDD) < 500: HR 0.45, 95% CI 0.16–1.28; cDDD ≥ 500: HR 0.19, 95% CI 0.04–0.80; p trend = 0.008) in the propensity score-matched cohort. Statin use was associated with a lower risk of GC recurrence in H. pylori-negative patients with resected EGC in a dose-response relationship.

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9 Long-Term Follow-up Study About Preventive Effect of H. pylori Eradication for the Incidence of Metachronous Gastric Cancer After Endoscopic Resection of Primary Early Gastric Cancer

Gastroenterology ◽

10.1016/s0016-5085(12)60009-2 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-3 ◽

Cited By ~ 6

Author(s):

Mototsugu Kato ◽

Masahiro Asaka ◽

Shogo Kikuch

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Preventive Effect ◽

Follow Up Study ◽

Long Term Follow Up ◽

Metachronous Gastric Cancer ◽

H Pylori

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Characteristics of Helicobacter pylori infection in a National Referral Hospital in Bhutan

Bhutan Health Journal ◽

10.47811/bhj.93 ◽

2020 ◽

Vol 6 (1) ◽

pp. 6-10

Author(s):

Chhabi Lal Adhikari ◽

Guru Prasad Dhakal ◽

Nongluck Suwisith ◽

Sonam Dargay ◽

Krishna P Sharma

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Age Groups ◽

Referral Hospital ◽

Upper Gastrointestinal Endoscopy ◽

Age Group ◽

Exact Test ◽

Significant Difference ◽

H Pylori ◽

National Referral Hospital

Introduction: Helicobacter pylori (H. pylori) is a bacterium causing chronic gastric infection and may cause gastric cancer. It was necessary to see the trend of infection, especially in symptomatic patients. This retrospective descriptive study was aimed to describe the characteristics of H. pylori infection in Bhutanese patients referred for an endoscopy to the National Referral Hospital, Thimphu. Methods: The sample of the study was randomized 380 medical records of the patients who underwent upper gastrointestinal endoscopy and Rapid Urea Test for symptomatic dyspepsia and peptic ulcer. Data was collected using a survey form designed by the researchers. Data analysis was done using descriptive statistics and either Chi-square or Fisher’s exact test. Results: The prevalence of H. pylori infection was very high (76.6%). The mean age of the infection was 42 with a range from 15 to 84 years. The highest prevalence of infection was observed in the age group 20-29 years (82.7%) and lowest in the oldest age group 70-84 years (66.7%). The analysis showed no significant difference in infection amongst age groups, gender, and endoscopic findings to the positive results at 5% significant level except for monthly prevalence (p<0.001). Gastritis was the commonest endoscopy finding (153/380) and gastro-duodenitis had the highest positivity rate (88.9%). Conclusion: The prevalence of infection was relatively high compared with previous studies. Young and middle-aged adults had a high prevalence and this group needs to be given priority for screening and eradication treatment considering limited resources to prevent associated gastric cancer in Bhutan.

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Does Helicobacter pylori Eradication Reduce the Incidence of Metachronous Gastric Cancer After Curative Endoscopic Resection of Early Gastric Cancer

Journal of Clinical Gastroenterology ◽

10.1097/mcg.0000000000001195 ◽

2020 ◽

Vol 54 (3) ◽

pp. 235-241 ◽

Cited By ~ 4

Author(s):

Bochao Zhao ◽

Jiale Zhang ◽

Di Mei ◽

Rui Luo ◽

Huiwen Lu ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Helicobacter Pylori Eradication ◽

Metachronous Gastric Cancer

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Mo1077 Extensive Mucosal Atrophy Quantified by Serum Pepsinogen Levels Can Predict Metachronous Gastric Cancer Development After Endoscopic Resection Regardless of Helicobacter pylori Eradication

Gastroenterology ◽

10.1016/s0016-5085(15)32022-9 ◽

2015 ◽

Vol 148 (4) ◽

pp. S-598

Author(s):

Mikitaka Iguchi ◽

Jun Kato ◽

Yasuhide Yamamoto ◽

Kenichiro Nakachi ◽

Takeichi Yoshida ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Endoscopic Resection ◽

Cancer Development ◽

Serum Pepsinogen ◽

Helicobacter Pylori Eradication ◽

Mucosal Atrophy ◽

Metachronous Gastric Cancer

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Follow-up analysis and histopathological study of gastric mucosa in patients with Helicobacter pylori infection

Journal of International Medical Research ◽

10.1177/03000605211055397 ◽

2021 ◽

Vol 49 (12) ◽

pp. 030006052110553

Author(s):

Guang Zhao ◽

Zhishang Zhang ◽

Baohui Li ◽

Silin Huang ◽

Wensi Li ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Intraepithelial Neoplasia ◽

Mucosal Damage ◽

Helicobacter Pylori Infection ◽

Gastric Mucosal Damage ◽

Histopathological Study ◽

Significant Difference ◽

H Pylori

Objective To investigate the histomorphological characteristics of the gastric mucosa and the prognosis in patients with Helicobacter pylori infection. Methods Progressive damage to the gastric mucosa was examined by immunohistochemistry in 2294 patients with H. pylori infection and follow-up information was analyzed. Results H. pylori initially colonized the mucus layer covered by the gastric mucosa epithelium, then selectively adhered to and destroyed the surface mucus cells causing intra-gastric and extra-gastric lesions. Gastric mucosal damage induced by H. pylori was divided into five stages according to the depth of H. pylori invasion and degree of lesion deterioration: mucilaginous, surface mucocellular, lamina propria lesion, mucosal atrophy, and intraepithelial neoplasia stages. Morphological follow-up analysis revealed no significant difference in 6-month curative effects between stage I and stage II, but significant differences were found between stages II and III, stages III and IV, and between stages IV and stage V, respectively. Conclusions This novel staging strategy may be a valuable tool for diagnosing and predicting the results of gastric mucosal damage induced by H. pylori infection.

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