Helicobacter pylori Eradication and Gastric Cancer: When Is the Horse Out of the Barn?

de Vries, A. C.; Kuipers, E. J.; Rauws, E. A. J.
June 2009
American Journal of Gastroenterology;Jun2009, Vol. 104 Issue 6, p1342
Academic Journal
Helicobacter pylori infection is a major risk factor for gastric cancer development. Therefore, H. pylori eradication may be an important approach in the prevention of gastric cancer. However, long-term data proving the efficacy of this approach are lacking. This report describes two patients who developed gastric cancer at, respectively, 4 and 14 years after H. pylori eradication therapy. These patients were included in a study cohort of H. pylori-infected subjects who received anti-H. pylori therapy during the early years of development of H. pylori eradication therapy and underwent strict endoscopic follow-up for several years. In both patients, gastric ulcer disease and premalignant gastric lesions, i.e., intestinal metaplasia at baseline and dysplasia during follow-up, were diagnosed before gastric cancer development. These case reports demonstrate that H. pylori eradication does not prevent gastric cancer development in all infected patients after long-term follow-up. In patients with premalignant gastric lesions, in particular in patients with a history of gastric ulcer disease, adequate endoscopic follow-up is essential for early detection of gastric neoplasia.Am J Gastroenterol 2009; 104:1342–1345; doi:10.1038/ajg.2008.15


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