Helicobacter pylori Eradication Prevents Metachronous Gastric Neoplasms after Endoscopic Resection of Gastric Dysplasia

Seung Hwan Shin; Da Hyun Jung; Jie-Hyun Kim; Hyun Soo Chung; Jun Chul Park; Sung Kwan Shin; Sang Kil Lee; Yong Chan Lee

doi:10.1371/journal.pone.0143257

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Helicobacter pylori Eradication Prevents Metachronous Gastric Neoplasms after Endoscopic Resection of Gastric Dysplasia

Authors: Seung Hwan Shin ; Da Hyun Jung ; Jie-Hyun Kim ; Hyun Soo Chung ; Jun Chul Park ; Sung Kwan Shin ; Sang Kil Lee ; Yong Chan Lee

Citation: PLOS ONE, Vol.10(11) : e0143257, 2015

Journal Title: PLOS ONE

Issue Date: 2015

MeSH: Aged ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use* ; Carcinoma in Situ/drug therapy* ; Carcinoma in Situ/microbiology ; Carcinoma in Situ/pathology ; Carcinoma in Situ/surgery ; Clarithromycin/therapeutic use ; Female ; Gastric Mucosa/drug effects ; Gastric Mucosa/microbiology ; Gastric Mucosa/pathology ; Gastric Mucosa/surgery ; Gastroscopy ; Helicobacter Infections/drug therapy* ; Helicobacter Infections/microbiology ; Helicobacter Infections/pathology ; Helicobacter Infections/surgery ; Helicobacter pylori/drug effects ; Helicobacter pylori/pathogenicity ; Helicobacter pylori/physiology ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/microbiology ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/prevention & control* ; Neoplasms, Second Primary/microbiology ; Neoplasms, Second Primary/pathology ; Neoplasms, Second Primary/prevention & control* ; Proton Pump Inhibitors/therapeutic use ; Retrospective Studies ; Stomach/drug effects ; Stomach/microbiology ; Stomach/pathology ; Stomach/surgery ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/microbiology ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery

Abstract: PURPOSE: There is insufficient data about the role of eradication of H. pylori after endoscopic resection (ER) for gastric dysplasia. The aim was to investigate the benefit of H. pylori eradication after ER in patients with gastric dysplasia to prevent metachronous gastric neoplasms.

MATERIALS AND METHODS: We retrospectively reviewed 1872 patients who underwent ER of gastric dysplasia. We excluded patients with a follow-up period of <2 years or who had not undergone tests for active H. pylori infection. A total of 282 patients were enrolled. The patients were categorized into those without active H. pylori infection (H. pylori-negative group, n = 124), those who successfully underwent H. pylori eradication (eradicated group, n = 122), and those who failed or did not undergo H. pylori eradication (persistent group, n = 36).

RESULTS: Metachronous recurrence was diagnosed in 36 patients, including 19 in the H. pylori-negative group, 10 in the eradicated group, and 7 in the persistent group. The cumulative incidence of metachronous recurrence was significantly lower in the H. pylori-eradicated group in comparison with either of the H. pylori-persistent (non-eradicated or failed) groups (p = 0.039). Similarly, the incidence of metachronous recurrence was significantly lower in the H. pylori-eradicated group compared with the H. pylori-negative group (p = 0.041).

CONCLUSION: Successful H. pylori eradication may reduce the development of metachronous gastric neoplasms after ER in patients with gastric dysplasia.