Dr Ping-I Hsu and colleagues from Taiwan investigated the impact of Helicobacter pylori infection on the development of various gastric malignancies.
|Gastric adenocarcinoma developed in 7 subjects with H pylori|
|The American Journal of Gastroenterology|
The team prospectively followed up 1225 dyspeptic patients.
The patients had nonulcer dyspepsia, gastric ulcers, or duodenal ulcers at enrollment.
Among the patients, 618 had H pylori infection and 607 did not.
Patients underwent endoscopy at enrollment and at 1- to 3-year intervals thereafter.
The researchers found during a mean follow-up of 6 years, gastric adenocarcinoma developed in 7 of the 618 H pylori-infected patients.
However, the team observed no gastric adenocarcinoma in any of the 607 uninfected patients.
The incidence of gastric lymphoma was less than 1% in H pylori-infected patients.
The research team observed no gastric lymphoma in uninfected patients.
Taken together, the development rate of gastric malignancy in H pylori-infected patients was higher than that in uninfected patients.
The team found among H pylori-infected subjects, the incidence of gastric malignancy was similar between those receiving and not receiving eradication therapy.
The researchers showed that intestinal metaplasia was the only independent factor predicting subsequent gastric malignancy in H pylori-infected subjects.
The odds ratio for intestinal metaplasia predicting gastric malignancy in subjects with H pylori was 5.
Dr Hsu's team concluded, "In this prospective cohort study, all gastric malignancies, including adenocarcinoma and lymphoma, developed in H pylori-infected patients."
"The finding implies that H pylori is a necessary cause of most gastric malignancies."
"Follow-up for H pylori-infected patients who have intestinal metaplasia is indicated."