BACKGROUND: We previously reported that eradication of Helicobacter pylori could reduce the risk of developing gastric cancer in patients with peptic ulcer diseases. In the present study, we further followed up our patient groups to identify factors associated with the development of gastric cancer. METHODS: Prospective posteradication evaluations were conducted in 1342 consecutive patients (1191 men and 151 women; mean age, 50 years) with peptic ulcer disease who had received H. pylori eradication therapy. The patients had undergone endoscopic examination before eradication therapy to evaluate peptic ulcers, background gastric mucosa, and H. pylori infection. After confirmation of eradication, follow-up endoscopy was performed yearly. RESULTS: A total of 1131 patients were followed for up to 9.5 years (mean, 3.9 years). Gastric cancer developed in 9 of 953 patients cured of infection and in 4 of 178 who had persistent infection (P=0.04). The risk of developing gastric cancer after receiving H. pylori eradication therapy was increased according to the grade of baseline gastric mucosal atrophy (P=0.01). In patients with peptic ulcer diseases, persistent infection of H. pylori (hazard ratio, 3.9; P=0.03), the grade of baseline gastric mucosal atrophy (3.3, P=0.01) and age (2.0, P=0.04) were identified as significant risk factors for developing gastric cancer. CONCLUSIONS: The grade of gastric atrophy was closely related to the development of gastric cancer after receiving H. pylori eradication therapy. Thus, eradication of H. pylori before the significant expansion of atrophy is most beneficial to prevent gastric cancer.
BACKGROUND: We previously reported that eradication of Helicobacter pylori could reduce the risk of developing gastric cancer in patients with peptic ulcer diseases. In the present study, we further followed up our patient groups to identify factors associated with the development of gastric cancer. METHODS: Prospective posteradication evaluations were conducted in 1342 consecutive patients (1191 men and 151 women; mean age, 50 years) with peptic ulcer disease who had received H. pylori eradication therapy. The patients had undergone endoscopic examination before eradication therapy to evaluate peptic ulcers, background gastric mucosa, and H. pyloriinfection. After confirmation of eradication, follow-up endoscopy was performed yearly. RESULTS: A total of 1131 patients were followed for up to 9.5 years (mean, 3.9 years). Gastric cancer developed in 9 of 953 patients cured of infection and in 4 of 178 who had persistent infection (P=0.04). The risk of developing gastric cancer after receiving H. pylori eradication therapy was increased according to the grade of baseline gastric mucosal atrophy (P=0.01). In patients with peptic ulcer diseases, persistent infection of H. pylori (hazard ratio, 3.9; P=0.03), the grade of baseline gastric mucosal atrophy (3.3, P=0.01) and age (2.0, P=0.04) were identified as significant risk factors for developing gastric cancer. CONCLUSIONS: The grade of gastric atrophy was closely related to the development of gastric cancer after receiving H. pylori eradication therapy. Thus, eradication of H. pylori before the significant expansion of atrophy is most beneficial to prevent gastric cancer.
Authors: A Kimura; S Tsuji; M Tsujii; H Sawaoka; H Iijima; N Kawai; M Yasumaru; Y Kakiuchi; Y Okuda; Z Ali; Y Nishimura; Y Sasaki; S Kawano; M Hori Journal: Prostaglandins Leukot Essent Fatty Acids Date: 2000-11 Impact factor: 4.006
Authors: N Sakaki; T Arakawa; H Katou; K Momma; N Egawa; T Kamisawa; Y Yamada; Y Tu; C Ishikawa; J Ishiwata Journal: J Gastroenterol Date: 1997-02 Impact factor: 7.527
Authors: K Haruma; M Mihara; E Okamoto; H Kusunoki; M Hananoki; S Tanaka; M Yoshihara; K Sumii; G Kajiyama Journal: Aliment Pharmacol Ther Date: 1999-02 Impact factor: 8.171
Authors: B Annibale; E Di Giulio; P Caruana; E Lahner; G Capurso; C Bordi; G Delle Fave Journal: Aliment Pharmacol Ther Date: 2002-10 Impact factor: 8.171
Authors: K Satoh; K Kimura; Y Taniguchi; Y Yoshida; K Kihira; T Takimoto; H Kawata; K Saifuku; K Ido; T Takemoto; Y Ota; M Tada; M Karita; N Sakaki; Y Hoshihara Journal: Am J Gastroenterol Date: 1996-05 Impact factor: 10.864