Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.
The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan.
Helicobacter. 2018 Aug;23(4):e12503. doi: 10.1111/hel.12503. Epub 2018 Jun 20.
Helicobacter pylori eradication therapy is commonly performed to reduce the incidence of gastric cancer. However, gastric cancer is occasionally discovered even after successful eradication therapy. Therefore, we examined the prognosis of gastric cancer patients, diagnosed after successful H. pylori eradication therapy.
All-cause death rates and gastric cancer-specific death rates in gastric cancer patients who received successful H. pylori eradication treatment was tracked and compared to rates in patients who did not receive successful eradication therapy.
In total, 160 gastric cancer patients were followed-up for up to 11.7 years (mean 3.5 years). Among them, 53 gastric cancer patients received successful H. pylori eradication therapy prior to gastric cancer diagnosis. During the follow-up period, 11 all-cause deaths occurred. In the successful eradication group, the proportion of patients with cancer stage I was higher. The proportions of patients who received curative endoscopic therapy and endoscopic examination in the 2 years prior to gastric cancer diagnosis were also higher in the successful eradication group. Kaplan-Meier analysis of all-cause death and gastric cancer-specific death revealed a lower death rate in patients in the successful eradication group (P = .0139, and P = .0396, respectively, log-rank test). The multivariate analysis showed that endoscopy within 2 years before cancer diagnosis is associated with stage I cancer.
Possible early discovery of gastric cancer after H. pylori eradication due to regular endoscopic surveillance may contribute to better prognosis of patients with gastric cancer.
根除幽门螺杆菌(H. pylori)治疗通常用于降低胃癌的发生率。然而,即使在成功根除治疗后,仍偶尔会发现胃癌。因此,我们检查了成功根除 H. pylori 治疗后诊断为胃癌的患者的预后。
对接受成功 H. pylori 根除治疗的胃癌患者的全因死亡率和胃癌特异性死亡率进行了跟踪,并与未接受成功根除治疗的患者的死亡率进行了比较。
共有 160 例胃癌患者接受了长达 11.7 年(平均 3.5 年)的随访。其中,53 例胃癌患者在诊断为胃癌前接受了成功的 H. pylori 根除治疗。在随访期间,有 11 例发生全因死亡。在成功根除组中,Ⅰ期癌症患者的比例更高。在诊断为胃癌前的 2 年内,接受根治性内镜治疗和内镜检查的患者比例在成功根除组中也更高。全因死亡和胃癌特异性死亡的 Kaplan-Meier 分析显示,成功根除组的死亡率较低(P =.0139 和 P =.0396,对数秩检验)。多变量分析显示,癌症诊断前 2 年内的内镜检查与Ⅰ期癌症有关。
由于定期进行内镜监测,可能会在根除 H. pylori 后早期发现胃癌,从而有助于改善胃癌患者的预后。