Seta Takeshi, Takahashi Yoshimitsu, Noguchi Yoshinori, Shikata Satoru, Sakai Tatsuya, Sakai Kyoko, Yamashita Yukitaka, Nakayama Takeo
Department of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
PLoS One. 2017 Aug 17;12(8):e0183321. doi: 10.1371/journal.pone.0183321. eCollection 2017.
Helicobacter pylori infection is strongly associated with gastric cancer occurrence. However, it is unclear whether eradication therapy reduces the risk of gastric cancer occurrence. We evaluated whether H. pylori eradication reduces the risk of primary gastric cancer by using both risk ratio (RR) and risk difference (RD).
Searches of PubMed, EMBASE, Google scholar, the Cochrane Library, and the Japan Medical Abstracts Society as well as those registered in databases of the Cochrane Central Register of Controlled Trials, metaRegister of Controlled Trials, ClinicalTrials.gov, controlled-trials.com, UMIN-CTR, JMACCT-CTR, and JAPIC-CTI between January 1965 and March 2017, supplemented with manual screening. Randomized controlled trials (RCTs) in which eradication therapy were implemented for the interventional group but not for the control group, and assessed the subsequent occurrence of primary gastric cancer as the main outcome. Two authors independently reviewed articles and extracted data. Integrated results for all data were presented as RR and RD.
Seven studies met inclusion criteria. The reductions in risk of primary gastric cancer occurrence in terms of overall RR and RD were 0.67 (95% CI: 0.48 to 0.95) and -0.00 ([95% CI: -0.01 to 0.00]; number needed to treat: 125.5 [95% CI: 70.0 to 800.9]), respectively.
The effectiveness of H. pylori eradication therapy in suppressing the occurrence of primary gastric cancer was significant and comparable to that of previous studies in terms of the estimated RR. However, the estimated RD was slight and not statistically significant.
幽门螺杆菌感染与胃癌发生密切相关。然而，根除治疗是否能降低胃癌发生风险尚不清楚。我们通过风险比（RR）和风险差（RD）评估了幽门螺杆菌根除是否能降低原发性胃癌的风险。
检索了PubMed、EMBASE、谷歌学术、Cochrane图书馆、日本医学摘要协会，以及Cochrane对照试验中央注册库、对照试验元注册库、ClinicalTrials.gov、controlled-trials.com、UMIN-CTR、JMACCT-CTR和JAPIC-CTI数据库中1965年1月至2017年3月期间的文献，并辅以人工筛选。纳入干预组实施根除治疗而对照组未实施根除治疗的随机对照试验（RCT），并将原发性胃癌的后续发生情况作为主要结局进行评估。两位作者独立审阅文章并提取数据。所有数据的综合结果以RR和RD表示。
七项研究符合纳入标准。原发性胃癌发生风险的总体RR和RD降低分别为0.67（95%CI：0.48至0.95）和-0.00（[95%CI：-0.01至0.00]；需治疗人数：125.5[95%CI：70.0至800.9]）。
幽门螺杆菌根除治疗在抑制原发性胃癌发生方面的有效性显著，就估计的RR而言与先前研究相当。然而，估计的RD轻微且无统计学意义。
