Proton pump inhibitor use and the risk of metachronous gastric cancer after H. pylori eradication in patients who underwent endoscopic resection for gastric neoplasms: A population-based cohort study

IF 6.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Alimentary Pharmacology & Therapeutics Pub Date : 2023-08-17 DOI:10.1111/apt.17676

Eun Jeong Gong, Hye-Kyung Jung, Bora Lee, Jitaek Hong, Jong Wook Kim, Cheol Min Shin, Young Hoon Youn, Kwang Jae Lee

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引用次数: 4

Abstract

Background

The association between proton pump inhibitors (PPI) use and gastric cancer remains controversial.

Aims

To investigate the impact of long-term PPI use on metachronous gastric cancer after Helicobacter pylori eradication in high-risk patients who underwent endoscopic resection of gastric neoplasms.

Methods

Using the Korean National Health Insurance Services database, we identified 1836 PPI users and 12,218 non-users among patients who received H. pylori eradication therapy after endoscopic resection for gastric neoplasms between 2009 and 2014. We then compared the incidence of metachronous gastric cancer between the PPI user and non-user groups. We conducted sensitivity analysis using various time lags and propensity score-matched analysis to ensure the robustness of the results.

Results

After a median follow-up of 7.3 years, the incidence of metachronous gastric cancer was significantly higher in the PPI user group than in the non-user group, with a crude hazard ratio of 6.20 (95% confidence interval, 5.78–6.65). After adjustment, PPI use was associated with the development of metachronous gastric cancer, with an adjusted hazard ratio of 5.51 (95% confidence interval, 5.12–5.92). The PPI user group was categorised into three subgroups according to the cumulative PPI dose; the increased risk of metachronous gastric cancer remained significant regardless of the PPI dose. Moreover, these results remained robust after applying various time lags and propensity score-matched analyses.

Conclusions

Long-term PPI use is associated with an increased risk of metachronous gastric cancer in patients who undergo H. pylori eradication therapy after endoscopic resection of gastric neoplasms.

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质子泵抑制剂的使用和胃镜切除胃肿瘤患者幽门螺杆菌根除后异时性胃癌的风险:一项基于人群的队列研究

背景质子泵抑制剂(PPI)的使用与胃癌之间的关系仍然存在争议。目的探讨内镜下切除胃肿瘤的高危患者幽门螺杆菌根除后长期使用PPI对异时性胃癌的影响。方法利用韩国国民健康保险服务数据库，我们在2009年至2014年期间胃肿瘤内镜切除后接受幽门螺杆菌根除治疗的患者中确定了1836名PPI使用者和12218名非PPI使用者。然后，我们比较了使用PPI组和不使用PPI组之间的异时性胃癌发生率。我们使用各种时间滞后和倾向得分匹配分析进行敏感性分析，以确保结果的稳健性。结果中位随访7.3年，使用PPI组异时性胃癌的发生率明显高于未使用PPI组，粗风险比为6.20(95%可信区间为5.78 ~ 6.65)。调整后，PPI的使用与异时性胃癌的发生相关，调整后的风险比为5.51(95%可信区间为5.12-5.92)。PPI使用者组根据PPI累积剂量分为3个亚组;无论PPI剂量如何，异时性胃癌的风险增加仍然显著。此外，在应用各种时间滞后和倾向评分匹配分析后，这些结果仍然稳健。结论:胃肿瘤内镜切除术后接受幽门螺杆菌根除治疗的患者长期使用PPI与异时性胃癌的风险增加相关。

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

Alimentary Pharmacology & Therapeutics 医学-胃肠肝病学

CiteScore

15.60

自引率

7.90%

发文量

527

审稿时长

3-6 weeks

期刊介绍： Alimentary Pharmacology & Therapeutics is a global pharmacology journal focused on the impact of drugs on the human gastrointestinal and hepato-biliary systems. It covers a diverse range of topics, often with immediate clinical relevance to its readership.