AUTHOR=Yu Tian-Hang , Bai Dan , Liu Kai , Zhang Wei-Han , Chen Xin-Zu , Hu Jian-Kun 

TITLE=Helicobacterpylori eradication following endoscopic resection might prevent metachronous gastric cancer: a systematic review and meta-analysis of studies from Japan and Korea

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1393498

DOI=10.3389/fmed.2024.1393498

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Objectives</title><p>A systematic review and meta-analysis was performed to evaluate the preventive effectiveness of <italic>Helicobacter pylori</italic> eradication against metachronous gastric cancer (MGC) or dysplasia following endoscopic resection (ER) for early gastric cancer (EGC) or dysplasia.</p></sec><sec id="sec2"><title>Methods</title><p>PubMed, Cochrane Library, MEDLINE, and EMBASE were searched until 31 October 2023, and randomized controlled trials or cohort studies were peer-reviewed. The incidence of metachronous gastric lesions (MGLs) including MGC or dysplasia was compared between <italic>Helicobacter pylori</italic> persistent and negative groups, eradicated and negative groups, and eradicated and persistent groups.</p></sec><sec id="sec3"><title>Results</title><p>Totally, 21 eligible studies including 82,256 observations were analyzed. Compared to those never infected, <italic>Helicobacter pylori</italic> persistent group (RR = 1.58, 95% CI = 0.98–2.53) trended to have a higher risk of MGLs and significantly in partial subgroups, while the post-ER eradicated group (RR = 0.79, 95% CI = 0.43–1.45) did not increase the risk of MGLs. Moreover, successful post-ER eradication could significantly decrease the risk of MGLs (RR = 0.54, 95% CI = 0.44–0.65) compared to those persistently infected. Sensitivity analysis obtained generally consistent results, and no significant publication bias was found.</p></sec><sec id="sec4"><title>Conclusion</title><p>The persistent <italic>Helicobacter pylori</italic> infection trends to increase the post-ER incidence of MGC or dysplasia, but post-ER eradication can decrease the risk correspondingly. Post-ER screening and eradication of <italic>Helicobacter pylori</italic> have preventive effectiveness on MGC, and the protocol should be recommended to all the post-ER patients.</p><p><bold>Systematic review registration</bold>: The PROSPERO registration identification was CRD42024512101.</p></sec>