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Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis.
- Source :
-
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association [Gastric Cancer] 2016 Jan; Vol. 19 (1), pp. 166-75. Date of Electronic Publication: 2015 Jan 22. - Publication Year :
- 2016
-
Abstract
- Background: The effect of Helicobacter pylori (H. pylori) eradication on gastric cancer (GC) prevention is controversial. Intestinal metaplasia (IM) seems to be a "point of no return" in the precancerous cascade. We performed a meta-analysis of randomized controlled trials (RCTs) to illustrate this issue.<br />Materials and Methods: The MEDLINE, EMBASE, Cochrane Library were searched for relevant RCTs that were published in any language up to March 2014. By dividing participants into subgroups based on their baseline diagnoses as group <IM (normal, non-atrophic gastritis, atrophic gastritis) and group ≥ IM(intestinal metaplasia, dysplasia), the relative risk (RR) of GC in each study compared treatment group with control group were pooled using Mantel-Haenszel fixed-effect model and publication bias analyses were performed.<br />Results: Ten studies from eight RCTs were included in this analysis, for a total of 7,955 participants. H. pylori treatment compared with control significantly reduced the risk of GC, with a pooled RR of 0.64 (95% CI, 0.48-0.85). Subgroup analysis for patients with non-atrophic gastritis, atrophic gastritis (<IM) yielded a similar results (RR = 0.25, 95% CI, 0.08-0.81). But this difference was not observed in patients with intestinal metaplasia, dysplasia (≥ IM) (RR = 0.88; 95% CI, 0.59-1.31).<br />Conclusions: Our results suggested that patients with Intestinal metaplasia or dysplasia could not benefit from the H. pylori treatment on the risk of GC.
- Subjects :
- Gastric Mucosa microbiology
Gastritis, Atrophic complications
Gastritis, Atrophic microbiology
Gastritis, Atrophic pathology
Helicobacter Infections complications
Helicobacter Infections pathology
Humans
Metaplasia microbiology
Precancerous Conditions microbiology
Precancerous Conditions pathology
Precancerous Conditions prevention & control
Randomized Controlled Trials as Topic
Stomach Neoplasms microbiology
Gastric Mucosa pathology
Helicobacter Infections drug therapy
Stomach Neoplasms pathology
Stomach Neoplasms prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1436-3305
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
- Publication Type :
- Academic Journal
- Accession number :
- 25609452
- Full Text :
- https://doi.org/10.1007/s10120-015-0462-7