Zhong Bin, Xiong Zhizhong, Zheng Jiabo, Mohamed Saddam Ahmed, Sun Jiachen, Huang Dayin, Deng Zijian, Guo Jianping, Peng Junsheng, Wang Huashe, Lian Lei
Department of General Surgery (Department of Gastrointestinal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Er Heng Rd. Guangzhou, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
BMC Cancer. 2025 Jan 27;25(1):157. doi: 10.1186/s12885-025-13494-5.
Helicobacter pylori (H. pylori) infection may affect the efficacy of immunotherapy and adjuvant chemotherapy in gastric cancer patients. However, the role of H. pylori infection in neoadjuvant chemotherapy in patients with locally advanced gastric cancer (LAGC) remains unclear. This study investigated the effect of H. pylori infection on neoadjuvant chemotherapy and prognosis of patients with LAGC.
This retrospective study utilized data from patients with LAGC who underwent neoadjuvant chemotherapy and surgical treatment at the Sixth Affiliated Hospital of Sun Yat-sen University from January 1, 2010, to January 31, 2021. Patients were grouped according to their H. pylori infection status. The responses of the two groups to neoadjuvant chemotherapy and oncological outcomes were then compared.
A total of 239 patients were included in the analysis, and the baseline characteristics of the H. pylori-positive (n = 51) and H. pylori-negative (n = 188) groups were comparable. Further analysis revealed that H. pylori infection was significantly associated with the major pathological response (P = 0.009). Multivariate analysis showed that factors related to major pathological response included; age ≤ 50 (OR: 0.423, 95% CI: 0.194-0.925), H. pylori infection (OR: 0.396, 95% CI: 0.183-0.854), pathological stage T 3/4 (OR: 0.524, 95% CI: 0.288-0.954), and CA12-5 > 35 U/mL (OR: 0.345, 95% CI: 0.132-0.904). Both overall survival (OS) and disease-free survival (DFS) rates were poorer in the H. pylori-positive group than in the H. pylori-negative group (OS: Log-Rank P = 0.035; DFS: Log-Rank P = 0.029).
This cohort study indicated that H. pylori infection may be associated with tumor response to neoadjuvant chemotherapy and survival outcomes in patients with LAGC.
幽门螺杆菌（H. pylori）感染可能会影响胃癌患者免疫治疗和辅助化疗的疗效。然而，幽门螺杆菌感染在局部晚期胃癌（LAGC）患者新辅助化疗中的作用仍不清楚。本研究调查了幽门螺杆菌感染对LAGC患者新辅助化疗及预后的影响。
这项回顾性研究利用了2010年1月1日至2021年1月31日在中山大学附属第六医院接受新辅助化疗和手术治疗的LAGC患者的数据。根据幽门螺杆菌感染状况对患者进行分组。然后比较两组对新辅助化疗的反应和肿瘤学结局。
共有239例患者纳入分析，幽门螺杆菌阳性组（n = 51）和幽门螺杆菌阴性组（n = 188）的基线特征具有可比性。进一步分析显示，幽门螺杆菌感染与主要病理反应显著相关（P = 0.009）。多因素分析表明，与主要病理反应相关的因素包括：年龄≤50岁（比值比：0.423，95%置信区间：0.194 - 0.925）、幽门螺杆菌感染（比值比：0.396，95%置信区间：0.183 - 0.854）、病理分期T3/4（比值比：0.524，95%置信区间：0.288 - 0.954）以及CA12 - 5 > 35 U/mL（比值比：0.345，95%置信区间：0.132 - 0.904）。幽门螺杆菌阳性组的总生存期（OS）和无病生存期（DFS）率均低于幽门螺杆菌阴性组（OS：对数秩检验P = 0.035；DFS：对数秩检验P = 0.029）。
这项队列研究表明，幽门螺杆菌感染可能与LAGC患者对新辅助化疗的肿瘤反应及生存结局相关。
