M Blanca Piazuelo1, Luis E Bravo2, Robertino M Mera3, M Constanza Camargo4, Juan C Bravo2, Alberto G Delgado3, M Kay Washington5, Alicia Rosero6, Luz S Garcia2, Jose L Realpe7, Sandra P Cifuentes7, Douglas R Morgan8, Richard M Peek9, Pelayo Correa3, Keith T Wilson10. 1. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Mucosal Inflammation and Cancer, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: maria.b.piazuelo@vumc.org. 2. Department of Pathology, Universidad del Valle School of Medicine, Cali, Valle del Cauca, Colombia. 3. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. 4. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland. 5. Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee. 6. Universidad de Nariño, Pasto, Nariño, Colombia. 7. Fundación Hospital San Pedro, Pasto, Nariño, Colombia. 8. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Gastroenterology, Department of Medicine, University of Alabama, Birmingham, Alabama. 9. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Mucosal Inflammation and Cancer, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee. 10. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Mucosal Inflammation and Cancer, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee.
Abstract
BACKGROUND & AIMS: Helicobacter pylori eradication and endoscopic surveillance of gastric precancerous lesions are strategies to reduce gastric cancer (GC) risk. To our knowledge, this study is the longest prospective cohort of an H pylori eradication trial in a Hispanic population. METHODS: A total of 800 adults with precancerous lesions were randomized to anti-H pylori treatment or placebo. Gastric biopsy samples taken at baseline and 3, 6, 12, 16, and 20 years were assessed by our Correa histopathology score. A generalized linear mixed model with a participant-level random intercept was used to estimate the effect of H pylori status on the score over time. Logistic regression models were used to estimate progression by baseline diagnosis and to estimate GC risk by intestinal metaplasia (IM) subtype and anatomic location. RESULTS: Overall, 356 individuals completed 20 years of follow-up. Anti-H pylori therapy (intention-to-treat) reduced progression of the Correa score (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.38-0.93). H pylori-negative status had a beneficial effect on the score over time (P = .036). Among individuals with IM (including indefinite for dysplasia) at baseline, incidence rates per 100 person-years were 1.09 (95% CI, 0.85-1.33) for low-grade/high-grade dysplasia and 0.14 (95% CI, 0.06-0.22) for GC. Incomplete-type (vs complete-type) IM at baseline presented higher GC risk (OR, 13.4; 95% CI, 1.8-103.8). Individuals with corpus (vs antrum-restricted) IM showed an OR of 2.1 (95% CI, 0.7-6.6) for GC. CONCLUSIONS: In a high-GC-risk Hispanic population, anti-H pylori therapy had a long-term beneficial effect against histologic progression. Incomplete IM is a strong predictor of GC risk.
BACKGROUND & AIMS: Helicobacter pylori eradication and endoscopic surveillance of gastric precancerous lesions are strategies to reduce gastric cancer (GC) risk. To our knowledge, this study is the longest prospective cohort of an H pylori eradication trial in a Hispanic population. METHODS: A total of 800 adults with precancerous lesions were randomized to anti-H pylori treatment or placebo. Gastric biopsy samples taken at baseline and 3, 6, 12, 16, and 20 years were assessed by our Correa histopathology score. A generalized linear mixed model with a participant-level random intercept was used to estimate the effect of H pylori status on the score over time. Logistic regression models were used to estimate progression by baseline diagnosis and to estimate GC risk by intestinal metaplasia (IM) subtype and anatomic location. RESULTS: Overall, 356 individuals completed 20 years of follow-up. Anti-H pylori therapy (intention-to-treat) reduced progression of the Correa score (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.38-0.93). H pylori-negative status had a beneficial effect on the score over time (P = .036). Among individuals with IM (including indefinite for dysplasia) at baseline, incidence rates per 100 person-years were 1.09 (95% CI, 0.85-1.33) for low-grade/high-grade dysplasia and 0.14 (95% CI, 0.06-0.22) for GC. Incomplete-type (vs complete-type) IM at baseline presented higher GC risk (OR, 13.4; 95% CI, 1.8-103.8). Individuals with corpus (vs antrum-restricted) IM showed an OR of 2.1 (95% CI, 0.7-6.6) for GC. CONCLUSIONS: In a high-GC-risk Hispanic population, anti-H pylori therapy had a long-term beneficial effect against histologic progression. Incomplete IM is a strong predictor of GC risk.
Authors: Massimo Rugge; Alberto Meggio; Cecilia Pravadelli; Mattia Barbareschi; Matteo Fassan; Maria Gentilini; Manuel Zorzi; Giovanni De Pretis; David Y Graham; Robert M Genta Journal: Gut Date: 2018-01-06 Impact factor: 23.059
Authors: Lisette G Capelle; Annemarie C de Vries; Jelle Haringsma; Frank Ter Borg; Richard A de Vries; Marco J Bruno; Herman van Dekken; Jos Meijer; Nicole C T van Grieken; Ernst J Kuipers Journal: Gastrointest Endosc Date: 2010-04-09 Impact factor: 9.427
Authors: Wouter J den Hollander; I Lisanne Holster; Caroline M den Hoed; Lisette G Capelle; Tjon J Tang; Marie-Paule Anten; Ingrid Prytz-Berset; Ellen M Witteman; Frank Ter Borg; Gijsbert den Hartog; Marco J Bruno; Maikel Petrus Peppelenbosch; Wilco Lesterhuis; Michael Doukas; Ernst J Kuipers; Manon C W Spaander Journal: Gut Date: 2018-06-06 Impact factor: 23.059
Authors: Claudia Allemani; Tomohiro Matsuda; Veronica Di Carlo; Rhea Harewood; Melissa Matz; Maja Nikšić; Audrey Bonaventure; Mikhail Valkov; Christopher J Johnson; Jacques Estève; Olufemi J Ogunbiyi; Gulnar Azevedo E Silva; Wan-Qing Chen; Sultan Eser; Gerda Engholm; Charles A Stiller; Alain Monnereau; Ryan R Woods; Otto Visser; Gek Hsiang Lim; Joanne Aitken; Hannah K Weir; Michel P Coleman Journal: Lancet Date: 2018-01-31 Impact factor: 79.321
Authors: Y-J Hwang; N Kim; H S Lee; J B Lee; Y J Choi; H Yoon; C M Shin; Y S Park; D H Lee Journal: Aliment Pharmacol Ther Date: 2017-11-29 Impact factor: 8.171
Authors: Yvonne L Latour; Johanna C Sierra; Jordan L Finley; Mohammad Asim; Daniel P Barry; Margaret M Allaman; Thaddeus M Smith; Kara M McNamara; Paula B Luis; Claus Schneider; Justin Jacobse; Jeremy A Goettel; M Wade Calcutt; Kristie L Rose; Kevin L Schey; Ginger L Milne; Alberto G Delgado; M Blanca Piazuelo; Bindu D Paul; Solomon H Snyder; Alain P Gobert; Keith T Wilson Journal: JCI Insight Date: 2022-06-22
Authors: Meng Qing Xu; Ke Sun; Chong Cao; Hui Hui Yin; Xiao Jun Wang; Qi Hang Yin; Li Jie Wang; Lin Tao; Kui Wang; Feng Li; Wen Jie Zhang Journal: PLoS One Date: 2022-07-21 Impact factor: 3.752