Kolb Jennifer M, Ozbek Umut, Harpaz Noam, Holcombe Randall F, Ang Celina
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Gastrointest Oncol. 2017 Jun;8(3):583-588. doi: 10.21037/jgo.2017.01.22.
Helicobacter pylori (H pylori) infection is a known risk factor for gastric cancer (GC) and has been linked with gastroesophageal junction (GEJ) cancer. Studies examining the relationship between H. pylori infection, GC characteristics and prognosis are limited and have yielded conflicting results. We report on the clinicopathologic characteristics and oncologic outcomes of gastric and GEJ cancer patients with and without a history of H. pylori treated at our institution.
We retrospectively reviewed the medical records of patients over the age of 18 years who underwent curative resection for GEJ and GC at Mount Sinai Hospital between 2007 and 2012 who had histopathologic documentation of the presence or absence of H pylori infection. Demographic, clinical, pathologic, treatment characteristics and outcomes including recurrence-free survival (RFS) and overall survival (OS) were compared.
Ninety-five patients were identified. The majority of patients were male (61%), white (36%) or Asian (34%), with median age at diagnosis 64. Tumors were stage I (51%), stage II (23%), stage III (25%), and stage IV (1%). H pylori infection status was documented at the time of cancer diagnosis in 89 (94%) patients, and following cancer diagnosis and treatment in 6 (6%) patients. Younger age at diagnosis, Asian race and Lauren histologic classification were associated with H Pylori infection. H pylori positive patients exhibited higher 5-year OS and 5-year RFS compared to H pylori negative patients, though the difference was not statistically significant in either univariate or multivariate analyses.
In this retrospective series of predominantly early stage GC and GEJ cancers, H. pylori positive patients were significantly younger at cancer diagnosis and were more frequently Asian compared to H. pylori negative patients. Other demographic and histologic classifications except for Lauren histologic classification were similar between the two groups. H pylori positive patients appeared to have improved outcomes compared to H. pylori negative patients.
幽门螺杆菌（H pylori）感染是已知的胃癌（GC）风险因素，且与胃食管交界（GEJ）癌有关。研究幽门螺杆菌感染、胃癌特征与预后之间关系的研究有限，结果也相互矛盾。我们报告了在我们机构接受治疗的有或无幽门螺杆菌感染史的胃癌和胃食管交界癌患者的临床病理特征和肿瘤学结局。
我们回顾性分析了2007年至2012年在西奈山医院接受GEJ和GC根治性切除术、年龄在18岁以上且有幽门螺杆菌感染组织病理学记录的患者的病历。比较了人口统计学、临床、病理、治疗特征及包括无复发生存期（RFS）和总生存期（OS）在内的结局。
共确定了95例患者。大多数患者为男性（61%），白人（36%）或亚洲人（34%），诊断时的中位年龄为64岁。肿瘤分期为I期（51%）、II期（23%）、III期（25%）和IV期（1%）。89例（94%）患者在癌症诊断时记录了幽门螺杆菌感染状态，6例（6%）患者在癌症诊断和治疗后记录。诊断时年龄较小、亚洲种族和劳伦组织学分类与幽门螺杆菌感染相关。与幽门螺杆菌阴性患者相比，幽门螺杆菌阳性患者的5年总生存期和5年无复发生存期更高，尽管在单因素或多因素分析中差异均无统计学意义。
在这个主要为早期胃癌和胃食管交界癌的回顾性系列研究中，与幽门螺杆菌阴性患者相比，幽门螺杆菌阳性患者在癌症诊断时明显更年轻，且更常见为亚洲人。两组之间除劳伦组织学分类外的其他人口统计学和组织学分类相似。与幽门螺杆菌阴性患者相比，幽门螺杆菌阳性患者似乎预后更好。
