Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis
| Autor: | Liya Zhou, Shiyu Xiao, Wenjun Jiang, Jinzhe Liu, Sizhu Li |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Population Cochrane Library Gastroenterology Helicobacter Infections 03 medical and health sciences 0302 clinical medicine Risk Factors Stomach Neoplasms Early Medical Intervention Internal medicine medicine Humans education Neoplasm Staging education.field_of_study Helicobacter pylori biology business.industry Endoscopy Neoplasms Second Primary Publication bias biology.organism_classification Early Gastric Cancer 030220 oncology & carcinogenesis Relative risk Meta-analysis 030211 gastroenterology & hepatology business Gastric Neoplasm |
| Zdroj: | Journal of Gastroenterology. 54:226-237 |
| ISSN: | 1435-5922 0944-1174 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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