Rokkas Theodore, Rokka Androniki, Portincasa Piero
Gastroenterology Clinic, Henry Dunant Hospital, Athens, Greece (Theodore Rokkas).
Department of Internal Medicine, "Aldo Moro" University, Bari Medical School, Bari, Italy (Androniki Rokka, Piero Pontincasa).
Ann Gastroenterol. 2017;30(4):414-423. doi: 10.20524/aog.2017.0144. Epub 2017 Apr 7.
Increasing evidence has suggested that () eradication might prevent the development of gastric cancer (GC). This systematic review and meta-analysis aimed to better explore the role of eradication in preventing GC, with particular reference to patients with precancerous lesions at baseline histology.
Searches for human studies were performed through October 2016 and risk ratios (RRs), were obtained. Heterogeneity between studies was estimated using the Cochran Q test and values, whereas the possibility of publication bias was estimated with funnel plots. Additionally, we performed subgroup and sensitivity analyses.
In 26 studies suitable for meta-analysis (10 randomized controlled trials and 16 cohort studies) 52,363 subjects were included. The risk of GC among patients in whom was successfully eradicated was significantly lower than that among controls: pooled RRs [95% CI] 0.56 [0.48-0.66], Z= -7.27, P=0.00001. This finding applied separately for randomized controlled trials (0.65 [0.51-0.84], Z= -3.33, P=0.0009) and for cohort studies (0.51 [0.42-0.62], Z= -6.63, P=0.00001). Concerning eradication in patients with precancerous lesions, subgroup analyses showed that patients with non-atrophic or atrophic gastritis benefited from eradication for the risk of GC development, whereas those with intestinal metaplasia or dysplasia did not.
eradication is associated with a significantly lower risk of GC; this finding has significant implications for the prevention of this cancer. The benefit is maximized when eradication is applied at early stages of the infection.
越来越多的证据表明，（）根除可能预防胃癌（GC）的发生。本系统评价和荟萃分析旨在更好地探讨根除在预防GC中的作用，尤其参考基线组织学有癌前病变的患者。
检索截至2016年10月的人体研究并获得风险比（RRs）。使用Cochran Q检验和 值评估研究间的异质性，而用漏斗图评估发表偏倚的可能性。此外，我们进行了亚组分析和敏感性分析。
纳入26项适合荟萃分析的研究（10项随机对照试验和16项队列研究），共52363名受试者。成功根除（）的患者发生GC的风险显著低于对照组：合并RRs [95%CI] 0.56 [0.48 - 0.66]，Z = -7.27，P = 0.00001。这一发现分别适用于随机对照试验（0.65 [0.51 - 0.84]，Z = -3.33，P = 0.0009）和队列研究（0.51 [0.42 - 0.62]，Z = -6.63，P = 0.00001）。关于癌前病变患者的（）根除，亚组分析显示，非萎缩性或萎缩性胃炎患者因GC发生风险而从（）根除中获益，而肠化生或发育异常患者则未获益。
（）根除与显著降低的GC风险相关；这一发现对该癌症的预防具有重要意义。在感染早期应用（）根除时获益最大。
