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Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis

  • Shiyu Xiao
  • Sizhu Li
  • Liya Zhou
  • Wenjun Jiang
  • Jinzhe Liu
Review
  • 156 Downloads

Abstract

The impact of different Helicobacter pylori (H. pylori) status (H. pylori negative, H. pylori eradication and H. pylori persistence) on the development of metachronous gastric lesions after endoscopic resection of early gastric cancer is not well defined. Thus, a systematic review and meta-analysis was performed to investigate this relationship. Two authors independently searched the electronic databases (Pubmed, Embase, the Cochrane Library and Web of Science) through March 2018, without language restriction. Pooled risk ratio for metachronous gastric lesions with regard to H. pylori status was calculated using fixed- or random-effects models, and heterogeneity and publication bias were also measured. 20 eligible studies were finally identified in systematic review, and 17 out of 20 studies were further included in meta-analysis. H. pylori eradication was associated with overall 50% lower odds of metachronous events (RR = 0.50; 95 % CI 0.41–0.61). Pooled risk ratios for metachronous gastric neoplasm were 0.85 (95 % CI 0.43–1.68) between H. pylori-eradicated and -negative patients, and 0.63 (95 % CI 0.35–1.12) between H. pylori-negative and -persistent patients, respectively. In conclusion, based on the best available evidence, eradication of H. pylori can provide protection against secondary gastric neoplasm, and this quantitative benefit seemed greater than among asymptomatic individuals. Metachronous risk seems comparable between H. pylori-eradicated and -negative population, or between H. pylori-negative and -persistent patients.

Keywords

Helicobacter pylori Early gastric cancer Metachronous gastric neoplasm 

Notes

Acknowledgements

This article was supported by the National Natural Science Foundation of China (81672410).

Compliance with ethical standards

Conflict of interest

All authors have no potential conflict of interest relevant to this article.

Supplementary material

535_2018_1513_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)
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Supplementary material 3 (DOCX 15 kb)

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of GastroenterologyPeking University Third HospitalBeijingChina

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