Associations between colonization with Helicobacter pylori and risk of gastrointestinal tract cancers: An umbrella review of meta-analyses

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Clinical Investigation Pub Date : 2025-01-29 DOI:10.1111/eci.14394

Tiago Paiva Prudente, Eleazar Mezaiko, Henrique Nunes Pereira Oliva, Fernanda Paula Yamamoto-Silva, Brunno Santos de Freitas Silva, Isabela Oliveira Oliva, Harvey Risch

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引用次数: 0

Abstract

Background

Several studies have investigated the association between Helicobacter pylori colonization and gastrointestinal malignancies. However, inconsistent results have been found, leaving no clear consensus.

Materials and Methods

Umbrella review of meta-analyses of observational studies aiming to understand the association between Helicobacter pylori colonization and gastrointestinal cancers in humans. MEDLINE, the Cochrane Library of Systematic Reviews, EMBASE, Scopus and Google Scholar were searched from their inception to January 2025. Quality assessment was performed with the AMSTAR 2 tool. The study was registered on PROSPERO (CRD42024523832).

Results

Of 1320 records, 38 meta-analyses were included, investigating biliary tract, colorectal, oesophageal, gastric, liver and pancreatic cancers. After dealing with primary study overlap and updating meta-analyses with over 160 studies, Helicobacter pylori was positively associated with biliary tract [OR 2.67 (1.57–4.52)], colorectal [OR 1.40 (1.23–1.60)], gastric [OR 2.10 (1.34–3.31)], liver [OR 5.13 (3.14–8.38)] and pancreatic [OR 1.24 (1.04–1.48)] cancers, while oesophageal adenocarcinoma (EAC) was inversely associated with it [OR .58 (.46–.72)]. The cytotoxic-associated gene A (CagA) protein was positively associated with biliary [OR 2.19 (1.07–4.50)], colorectal [OR 2.04 (1.47–2.82)], oesophageal squamous cell carcinoma [OR 1.56 (1.30–1.89)] and gastric cancers [OR 2.53 (1.94–3.30)], and inversely associated with EAC [OR .60 (.44–.81)] and pancreatic [OR .85 (.75–.97)] cancers. Our results sprout from mostly critically low-quality meta-analyses and moderate to high quality primary studies.

Conclusion

Exposure to Helicobacter pylori colonization and its proteins is associated with not only gastric cancer, but also other GI tract cancers. Directionally different results may be seen when specific virulence factors/organ sites are investigated.

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幽门螺杆菌定殖与胃肠道癌症风险之间的关系：荟萃分析综述

背景：一些研究调查了幽门螺杆菌定植与胃肠道恶性肿瘤之间的关系。然而，发现了不一致的结果，没有明确的共识。材料和方法：对旨在了解幽门螺杆菌定植与人类胃肠道癌症之间关系的观察性研究的荟萃分析进行综述。MEDLINE、Cochrane系统评论图书馆、EMBASE、Scopus和谷歌Scholar从成立到2025年1月进行了检索。使用AMSTAR 2工具进行质量评估。该研究已在PROSPERO注册（CRD42024523832）。结果：在1320份记录中，纳入了38项荟萃分析，调查了胆道、结直肠癌、食道癌、胃癌、肝癌和胰腺癌。在处理了原始研究重叠和160多项研究的更新meta分析后，幽门螺杆菌与胆道癌[OR 2.67(1.57-4.52)]、结直肠癌[OR 1.40(1.23-1.60)]、胃癌[OR 2.10(1.34-3.31)]、肝癌[OR 5.13(3.14-8.38)]和胰腺癌[OR 1.24(1.04-1.48)]呈正相关，而食管腺癌（EAC）与幽门螺杆菌呈负相关[OR 0.58(0.46 - 0.72)]。细胞毒相关基因A （CagA）蛋白与胆道癌[OR 2.19(1.07-4.50)]、结直肠癌[OR 2.04(1.47-2.82)]、食管鳞状细胞癌[OR 1.56(1.30-1.89)]、胃癌[OR 2.53(1.94-3.30)]呈正相关，与EAC癌[OR 0.60(0.44 - 0.81)]、胰腺癌[OR 0.85(0.75 - 0.97)]呈负相关。我们的结果主要来自低质量的荟萃分析和中等到高质量的初步研究。结论：幽门螺杆菌定殖及其蛋白暴露不仅与胃癌有关，还与其他胃肠道肿瘤有关。当研究特定的毒力因子/器官部位时，可能会看到方向性不同的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.