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SYSTEMATIC REVIEW article
Front. Microbiol.
Sec. Microorganisms in Vertebrate Digestive Systems
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1530549
This article is part of the Research Topic The Gut Microbiome's Role in Gastric Cancer: Mechanisms and Therapies View all articles
Effect of Helicobacter pylori eradication on gastric cancer risk in patients with intestinal metaplasia or dysplasia: a meta-analysis of randomized controlled trials
Provisionally accepted- 1 Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
- 2 State Key Laboratory of Molecular Oncology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 3 Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Observational studies suggest that Helicobacter pylori (H. pylori) is associated with an increased risk of gastric cancer, yet the effect of H. pylori eradication on gastric cancer risk in patients with intestinal metaplasia (IM) or dysplasia remains controversial. The purpose of this study was to summarize the evidence from randomized controlled trials (RCTs) investigating H. pylori eradication on gastric cancer risk in patients with IM or dysplasia to determine the evidence base.PubMed, Embase, Cochrane Library, Web of science and China National Knowledge Internet database were searched for RCTs published through May 2024 in adults with IM or dysplasia comparing the risk of gastric cancer following H. pylori eradication versus no eradication therapy. Relative risk (RR) with its 95% confidence interval (CI) using random-effects model were employed for the effect estimate. Sensitivity, metaregression, and subgroup analyses were also calculated.Sixteen RCTs involving 15,027 patients with IM or dysplasia met the inclusion criteria.In a pooled analysis, H. pylori eradication resulted in a 45% reduction in RR for gastric cancer risk relative to no eradication (RR: 0.55; 95% CI: 0.46-0.67; P < 0.001). H. pylori eradication significantly reduced the risk of gastric cancer in patients with dysplasia (RR: 0.51; 95%CI: 0.32-0.82; P = 0.005), and IM (RR: 0.61; 95%CI: 0.40-0.93; P = 0.022). Further, if the study conducted in countries other than those in Asia, sample size < 500, percentage of male < 50.0%, follow-up duration < 5.0 years, and low study quality, then there was no significant association between H. pylori eradication and a decreased risk of gastric cancer.H. pylori eradication is protective against gastric cancer in patients with IM or dysplasia.
Keywords: Helicobacter pylori, gastric cancer, intestinal metaplasia, Dysplasia, metaanalysis Gastric cancer, Helicobacter pylori, Precursor, cancer risk, meta-analysis
Received: 19 Nov 2024; Accepted: 18 Feb 2025.
Copyright: © 2025 Fu, Yu, Liu, Chen, Chen, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ziyi Wang, State Key Laboratory of Molecular Oncology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
Wenya Li, Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110000, Liaoning Province, China
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