Department of Surgery, Onomichi General Hospital, Hiroshima, Japan.
Department of Digestive Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Cancer Rep (Hoboken). 2023 Dec;6(12):e1903. doi: 10.1002/cnr2.1903. Epub 2023 Sep 12.
BACKGROUND/AIMS: Helicobacter pylori (HP) eradication is recommended after endoscopic treatment of early gastric cancer (EGC). Cases of spontaneous HP resolution after partial gastrectomy due to environmental changes have been reported; however, there is no evidence for the efficacy of HP eradication in suppressing carcinogenesis and also no reports on the natural history of HP after partial gastrectomy in gastric cancer (GC). To report the natural history of HP in patients with GC and HP infection after partial gastrectomy.
We prospectively studied the rate of spontaneous disappearance of HP after partial gastrectomy in patients with GC. From April 2016 to May 2020, 80 patients underwent partial gastrectomy, including 9 cases of proximal gastrectomy (PG), and 71 cases of distal gastrectomy (DG). The presence of HP was confirmed in the stool antigen test 1 year after operation, HP infection persisted in 46 patients (57.5%) and disappeared in 34 patients (42.5%). In univariate analysis, only proton pump inhibitor (PPI) use was a significant contributing factor for the spontaneous resolution of HP infection, especially in the DG group. However, there was no difference in the rates of HP disappearance between Billroth-I and Roux-en-Y reconstructions in the DG group.
The HP spontaneously disappeared in 42.5% of the GC patients within 1 year after partial gastrectomy. Further investigation in a larger cohort is needed to elucidate the underlying mechanisms.
背景/目的：幽门螺杆菌（HP）的根除推荐用于早期胃癌（EGC）的内镜治疗后。有报道称，由于环境变化，部分胃切除术后 HP 会自发清除；然而，尚无关于 HP 根除抑制癌变的疗效的证据，也没有关于胃癌（GC）部分胃切除术后 HP 自然史的报告。本研究旨在报告 GC 患者和 HP 感染患者部分胃切除术后 HP 的自然史。
我们前瞻性研究了 GC 患者部分胃切除术后 HP 自发消失的比率。2016 年 4 月至 2020 年 5 月，80 例患者接受了部分胃切除术，包括 9 例近端胃切除术（PG）和 71 例远端胃切除术（DG）。术后 1 年通过粪便抗原试验确认 HP 的存在，46 例患者（57.5%）存在 HP 感染，34 例患者（42.5%）HP 消失。单因素分析发现，只有质子泵抑制剂（PPI）的使用是 HP 感染自发清除的显著影响因素，尤其是在 DG 组。然而，在 DG 组中，Billroth-I 和 Roux-en-Y 重建之间的 HP 消失率没有差异。
在部分胃切除术后 1 年内，42.5%的 GC 患者的 HP 自发消失。需要进一步在更大的队列中进行研究以阐明潜在机制。
