Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients
Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients
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DOI：
10.1111/apt.12633
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发表时间：
2014-03-01
影响因子：
7.6
通讯作者：
Jeon, S. W.
中科院分区：
文献类型：
--
作者：
Kwon, Y. H.;Heo, J.;Jeon, S. W.
背景早期胃癌内镜黏膜下剥离术（ESD）后根除幽门螺杆菌（Helicobacter pylori，Hp）是否能降低异时性胃粘膜异型增生和胃癌的发生率目的比较根除组和持续组异时性胃粘膜异型增生和胃癌的发生率。第二个终点是评估EGC.MethodsIn一个单一的中心，在2007年5月和2010年5月之间，有证据表明H。pylori感染的ESD EGC的时间，并进行了回顾性分析的随访数据。幽门螺杆菌感染在ESD的EGC的时间。214例患者（75.6%）成功根除（根除组），69例患者（24.4%）显示持续H。pylori感染（持续组）。持续组中13例（18.8%）发生异时性胃病变，根除组中18例（8.4%）发生异时性胃病变（P=0.016）。在≥ 60岁组中，异时性胃癌的累积发病率显示显著增加（P=0.012）。根除组和持续感染组的胃异时性病变累积危险比（OR=2.322，95% CI=1.136-4.744，P=0.021）和内镜切除术时年龄≥ 60岁（OR=2.803，95% CI=1.207-6.509，P=0.016）存在差异。pylori感染和高龄（>= 60岁）是异时性胃癌发病率增加的独立危险因素。
BackgroundWhether the incidence of metachronous gastric dysplasia and cancer could be decreased by eradication of Helicobacter pylori after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC).AimTo compare the incidence of metachronous gastric lesion in the eradicated group and the persistent group. Second end point is to evaluate the risk factors for metachronous gastric lesions after ESD for EGC.MethodsIn a single centre, between May 2007 and May 2010, the patients who had evidence of H. pylori infection at the time of ESD for EGC were included, and the follow-up data were analysed retrospectively.ResultsWe enrolled 283 patients who have shown H. pylori infection at the time of ESD for EGC. Successful eradication was achieved for 214 patients (75.6%) (Eradicated group), and 69 patients (24.4%) showed persistent H. pylori infection (Persistent group). Metachronous gastric lesions developed in 13 (18.8%) in the persistent group and 18 (8.4%) in the eradicated group (P=0.016). In the >= 60-year-old group, the cumulative incidence of metachronous gastric cancer showed a significant increase (P=0.012). Cumulative hazard ratio of subsequent gastric metachronous lesions differed between the eradication group and the persistent infection group (OR=2.322, 95% CI=1.136-4.744, P=0.021), and >= 60 age at the time of endoscopic resection (OR=2.803, 95% CI=1.207-6.509, P=0.016).ConclusionsBoth persistent H. pylori infection and old age (>= 60) are independent risk factors for the increased incidence of metachronous gastric cancer.