Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, Japan.
Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, Japan,
Digestion. 2019;99(1):59-65. doi: 10.1159/000494414. Epub 2018 Dec 14.
The incidence of gastric cancer occurring after successful Helicobacter pylori eradication has been increasing. We aimed to clarify the influence of eradication therapy on the ability to diagnose early gastric cancer after successful H. pylori eradication in patients who underwent annual endoscopic screening.
A total of 220 patients (179 men; mean age 71.0 years) had differentiated-type early gastric cancer that was discovered through annual endoscopic screening. Patients were categorized into 2 groups: the H. pylori-eradicated group (n = 81) and the non-eradicated control group (n = 139). After matching patients by propensity scores, we retrospectively analyzed the clinicopathological characteristics of 162 patients (81 patients in each group). Furthermore, we compared the characteristics of gastric cancer with submucosal invasion between the 2 groups.
The prevalence of early gastric cancer with submucosal invasion was significantly higher in the eradicated group than in the control group, both before propensity score matching (16.0 vs. 7.2%, respectively; p = 0.038) and after propensity score matching of 81 pairs (16.0 vs. 4.9%, respectively; p = 0.021). In the comparative analysis of gastric cancer with submucosal invasion, there was no difference between the 2 groups with respect to factors influencing the ability to diagnose its presence endoscopically.
H. pylori eradication therapy increased the prevalence of differentiated-type gastric cancer with submucosal invasion despite patients' completion of annual endoscopic screening after eradication.
成功根除幽门螺杆菌（H. pylori）后，胃癌的发病率一直在上升。我们旨在阐明根除治疗对接受年度内镜筛查的患者在成功根除 H. pylori 后诊断早期胃癌能力的影响。
共有 220 例（男 179 例；平均年龄 71.0 岁）接受了年度内镜筛查，发现分化型早期胃癌。患者分为 2 组：H. pylori 根除组（n = 81）和未根除对照组（n = 139）。通过倾向评分匹配患者后，我们回顾性分析了 162 例患者（每组 81 例）的临床病理特征。此外，我们比较了两组黏膜下浸润性胃癌的特征。
在未进行倾向评分匹配时，根除组早期胃癌黏膜下浸润的发生率明显高于对照组（16.0%比 7.2%；p = 0.038），在进行 81 对倾向评分匹配后，这一差异仍然存在（16.0%比 4.9%；p = 0.021）。在黏膜下浸润性胃癌的比较分析中，两组在影响内镜诊断存在的能力的因素方面没有差异。
尽管根除后患者完成了年度内镜筛查，但 H. pylori 根除治疗增加了黏膜下浸润性分化型胃癌的发生率。
