Zhejiang Chinese Medical University, Hangzhou, China.
Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Dig Dis. 2023;41(4):553-564. doi: 10.1159/000529493. Epub 2023 Mar 10.
Helicobacter pylori infection is strongly associated with gastric cancer. However, there is currently no consensus on the association between H. pylori and gastric cancer prognosis.
A systematic search was conducted on studies in PubMed, EMBASE, and Web of Science up to March 10, 2022. The quality of all included studies was assessed using the Newcastle-Ottawa Scale. The hazard ratio (HR) and its 95% confidence interval (95% CI) were extracted to analyze the association between H. pylori infection and prognosis of gastric cancer. In addition, subgroup analysis and publication bias were performed.
A total of 21 studies were involved. The pooled HR was 0.67 (95% CI, 0.56-0.79) for overall survival (OS) in H. pylori-positive patients, with the control (HR = 1) being the H. pylori-negative group. In the subgroup analysis, the pooled HR was 0.38 (95% CI, 0.24-0.59) for OS in H. pylori-positive patients who received surgery combined with chemotherapy. The pooled HR for disease-free survival was 0.74 (95% CI, 0.63-0.8) and 0.41 (95% CI, 0.26-0.65) in patients who received surgery combined with chemotherapy.
H. pylori-positive gastric cancer patients have a better overall prognosis than H. pylori-negative patients. H. pylori infection has improved the prognosis of patients undergoing surgery or chemotherapy, among which the improvement was most obvious in patients undergoing surgery combined with chemotherapy.
幽门螺杆菌感染与胃癌强烈相关。然而，目前对于幽门螺杆菌与胃癌预后之间的关系尚未达成共识。
系统检索了PubMed、EMBASE 和 Web of Science 上截至 2022 年 3 月 10 日的研究。使用纽卡斯尔-渥太华量表评估所有纳入研究的质量。提取风险比（HR）及其 95%置信区间（95%CI），以分析幽门螺杆菌感染与胃癌预后之间的关系。此外，还进行了亚组分析和发表偏倚检验。
共纳入 21 项研究。幽门螺杆菌阳性患者的总生存率（OS）的合并 HR 为 0.67（95%CI，0.56-0.79），对照组（HR=1）为幽门螺杆菌阴性组。在亚组分析中，接受手术联合化疗的幽门螺杆菌阳性患者的 OS 合并 HR 为 0.38（95%CI，0.24-0.59）。接受手术联合化疗的患者的无病生存率的合并 HR 分别为 0.74（95%CI，0.63-0.8）和 0.41（95%CI，0.26-0.65）。
与幽门螺杆菌阴性患者相比，幽门螺杆菌阳性的胃癌患者具有更好的总体预后。幽门螺杆菌感染改善了接受手术或化疗的患者的预后，其中在接受手术联合化疗的患者中改善最为明显。
