Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2016; 22(44): 9794-9802
Published online Nov 28, 2016. doi: 10.3748/wjg.v22.i44.9794
Association between Helicobacter pylori status and metachronous gastric cancer after endoscopic resection
Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim
Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
Author contributions: Lee SH, Kim KO, Jang BI and Kim TN designed research and supervised the report; Jeong YH, Sohn SH, Bae SI and Kim SB analyzed the data; Kim SB and Bae SI wrote the paper.
Supported by the 2015 Yeungnam University Research Grant.
Institutional review board statement: This study was reviewed and approved by the institutional review board of Yeungnam University Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no conflict-of-interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Si Hyung Lee, MD, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. dr9696@nate.com
Telephone: +82-53-6203985 Fax: +82-53-6238038
Received: July 22, 2016
Peer-review started: July 25, 2016
First decision: August 29, 2016
Revised: September 24, 2016
Accepted: October 27, 2016
Article in press: October 27, 2016
Published online: November 28, 2016
Processing time: 127 Days and 6.6 Hours
Abstract
AIM

To investigate the effect of Helicobacter pylori (H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer (MGC) after endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) and risk factors of MGC.

METHODS

The authors retrospectively reviewed the medical records of 433 patients (441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group (n = 257) and the H. pylori non-tested group (n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup (n = 120), the H. pylori-persistent subgroup (n = 42), and the H. pylori-negative subgroup (n = 95). Incidences of MGC and risk factors of MGC were identified.

RESULTS

Median follow-up duration after ESD was 30.00 mo (range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group (7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group (P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients.

CONCLUSION

H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.

Keywords: Metachronous gastric cancer; Endoscopic submucosal dissection; Helicobacter pylori

Core tip: This is a retrospective study to evaluate the effect of Helicobacter pylori (H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer (MGC) after endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) and risk factors of MGC. H. pylori status test and H. pylori eradication seems to have no preventive effect on the occurrence of MGC after ESD for EGC. The risk factors of MGC were endoscopic gastric mucosal atrophy in H. pylori tested group alone and intestinal metaplasia in all patients.