Helicobacter pylori Infection and Metachronous Gastric Cancer in Elderly Patients With Gastric Cancer Aged ≥ 75 Years Who Underwent Endoscopic Submucosal Dissection

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2025-09-01 DOI:10.1111/hel.70068

Young-Il Kim, Jong Yeul Lee, Chan Gyoo Kim, Il Ju Choi

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Abstract

Background and Aims

Helicobacter pylori (Hp) infection is associated with metachronous gastric cancer (GC) after endoscopic submucosal dissection resection (ESD) in patients with early GC (EGC), but this association has not been well investigated in elderly patients. This study investigated whether Hp infection status was associated with metachronous GC after ESD in patients aged ≥ 75 years.

Methods

This retrospective study involved 298 EGC patients aged ≥ 75 years who underwent ESD. The Hp-negative group (n = 233) included patients with negative or eradicated Hp infection, whereas the Hp-positive group (n = 65) included patients with persistently positive infection or failed eradication. The primary outcome was metachronous GC occurring at ≥ 1 year after ESD.

Results

The median patient age was 78 years (interquartile range [IQR]: 76–80 years). During a median follow-up of 4.4 years (IQR: 2.9–5.9 years), metachronous GC occurred in 16 (6.9% [16/233], 16.3 cases/1000 person-year) and 10 (15.4% [10/65], 37.5 cases/1000 person-year) patients in the Hp-negative and Hp-positive groups, respectively. The incidence of metachronous cancer was higher in the Hp-positive group than in the Hp-negative group (p = 0.035, log-rank test). In a multivariate analysis, persistent Hp infection was an independent risk factor for metachronous GC (age- and sex-adjusted hazard ratio, 2.33; 95% CI: 1.05–5.17).

Conclusions

Persistent H. pylori infection status was associated with a higher risk of metachronous GC, and H. pylori treatment needs to be provided in elderly patients aged ≥ 75 years and older with EGC undergoing ESD.

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年龄≥75岁高龄胃癌患者行内镜下粘膜夹层的幽门螺杆菌感染与异时性胃癌

背景与目的幽门螺杆菌（Hp）感染与早期胃癌（EGC）患者内镜下粘膜下剥离切除术（ESD）后的异时性胃癌（GC）相关，但这种相关性在老年患者中尚未得到很好的研究。本研究调查了年龄≥75岁的患者ESD后Hp感染状态是否与异时性GC相关。方法回顾性研究298例年龄≥75岁的EGC患者行ESD治疗。Hp阴性组（n = 233）包括Hp阴性或根除的患者，而Hp阳性组（n = 65）包括持续阳性感染或根除失败的患者。主要终点为发生在ESD后≥1年的异时性GC。结果患者年龄中位数为78岁（四分位数间距[IQR]: 76 ~ 80岁）。在中位随访4.4年（IQR: 2.9-5.9年）期间，hp阴性组和hp阳性组分别有16例（6.9%[16/233]，16.3例/1000人年）和10例（15.4%[10/65]，37.5例/1000人年）患者发生异时性GC。hp阳性组异时性癌的发生率高于hp阴性组（p = 0.035， log-rank检验）。在一项多变量分析中，持续性Hp感染是异时性GC的独立危险因素（年龄和性别调整后的危险比为2.33;95% CI: 1.05-5.17）。结论持续幽门螺杆菌感染与异时性胃癌发生风险增高相关，≥75岁高龄高龄高龄的EGC患者行ESD治疗需给予幽门螺杆菌治疗。

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

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.