The Effect of EradicatingHelicobacter Pylorion the Development of Gastric Cancer in Patients with Peptic Ulcer Disease

Take, Susumu; Mizuno, Motowo; Ishiki, Kuniharu; Nagahara, Yasuhiro; Yoshida, Tomowo; Yokota, Kenji; Oguma, Keiji; Okada, Hiroyuki; Shiratori, Yasushi
May 2005
American Journal of Gastroenterology;May2005, Vol. 100 Issue 5, p1037
Academic Journal
OBJECTIVES: Infection withHelicobacter pyloriis a risk factor for the development of gastric cancer. However, it is not known whether eradication therapy can prevent the development of gastric cancer in persons in whom the cancer is not yet established. In the present study, we investigated whether the eradication ofH. pyloriin patients with peptic ulcer disease reduces the likelihood of their developing gastric cancer.METHODS: Prospective posteradication evaluations were conducted in 1,342 consecutive patients (1,191 men and 151 women; mean age: 50 yr) with peptic ulcer diseases who had receivedH. pylorieradication therapy. After confirmation of eradication, endoscopy and a urea breath test were performed yearly.RESULTS: A total of 1,120 patients completed more than 1-yr follow-up and were followed for up to 8.6 yr (a mean of 3.4 yr). Gastric cancer developed in 8 of 944 patients cured of infection and 4 of 176 who had persistent infection (p= 0.04; log-rank test). All the gastric cancer developed in patients with gastric ulcer, but none in patients with duodenal ulcer (p= 0.005; Fisher's exact test). In patients with gastric ulcer, persistent infection was identified as a significant factor for the risk of developing gastric cancer (hazard ratio: 3.35; 95% confidence interval: 1.00–11.22;p= 0.04; Cox's proportional-hazards model).CONCLUSION: H. pylorieradication may reduce their risk of developing gastric cancer in patients with gastric ulcer. Large-scale studies in additional populations of this important international public-health issue are warranted.(Am J Gastroenterol 2005;100:1037–1042)


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