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News

Preneoplastic gastric lesions with H pylori

Findings in November's issue of Gut suggest that patients with preneoplastic gastric lesions should be treated and cured of their H pylori infection.

News image

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Helicobacter pylori infection induces progressive inflammatory changes in the gastric mucosa that may lead to gastric cancer.

Understanding long term effects resulting from the cure of this infection is needed to design cancer prevention strategies.

Professor Correa and colleagues from New Orleans assessed a cohort of 795 adults with preneoplastic gastric lesions.

The researchers randomized the patients to receive anti-H pylori treatment and/or antioxidants.

At the end of 6 years of intervention, those who did not receive anti-H pylori treatment were offered it.

Gastric biopsies were obtained at baseline, and at 3, 6, and 12 years.

The research team utilized a histopathology score to document changes in gastric lesions.

Preneoplastic gastric lesions regress at a rate equal to the square of time in patients free of H pylori

Gut

Non-linear mixed models were used to estimate the cumulative effect of H pylori clearance on histopathology scores.

The team adjusted the scores for follow up time, interventions, and confounders.

The researchers reported that 97% of patients were H pylori positive at baseline, and 53% were positive at 12 years.

Patients accumulated 1703 person years free of infection.

A multivariate model showed a significant regression in histopathology score as a function of the square of H pylori negative time.

The team noted that patients who were H pylori negative had 15% more regression and 14% less progression than those positive at 12 years.

The research team found that the rate of healing of gastric lesions occurred more rapidly as years free of infection accumulated.

The rate of healing of gastric lesions was more pronounced in less advanced lesions.

Professor Correa's team concludes, “Preneoplastic gastric lesions regress at a rate equal to the square of time in patients rendered free of H pylori infection.”

“Our findings suggest that patients with preneoplastic gastric lesions should be treated and cured of their H pylori infection.”

Gut 2005:54:1536-40
20 October 2005

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