A Close Follow-Up Strategy in the Short Period of Time after Helicobacter pylori Eradication Contributes to Earlier Detection of Gastric Cancer.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestion Pub Date : 2023-01-01 DOI:10.1159/000527476

Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Konomi Kobayashi, Tetsuo Morishita

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引用次数: 0

Abstract

Introduction: The purpose of this study was to optimize the surveillance frequency and period for efficient detection of early gastric cancer (EGC) after Helicobacter pylori (HP) eradication.

Methods: Data from patients with eradicated HP infection were extracted from the endoscopy databases of two institutions from January 2016 to March 2021. The patients were divided into a close follow-up group with frequent surveillance after eradication and an open follow-up group with an intermittent surveillance method, and the cases of post-eradication EGC found in the two groups were analyzed.

Results: Thirty-six out of 9,322 patients (0.39%) in the close follow-up group and 20 out of 11,436 patients (0.17%) in the open follow-up group were found to have EGC. The cumulative incidence of EGC after eradication was significantly higher in the close follow-up group (p = 0.004). The duration between eradication and EGC detection was significantly shorter in the close follow-up group (51.7 vs. 90.5 months, p = 0.002). A logistic regression model revealed that duration after eradication was an independent predictor for detecting EGC in the close follow-up group (p = 0.045). A Cox proportional hazards model revealed that the close follow-up strategy was effective in patients with an eradication duration of less than 65 months to identify EGC (p = 0.015), but there was no difference between the two strategies in patients with an eradication duration of more than 65 months (p = 0.624).

Discussion/conclusions: Frequent surveillance after HP eradication is efficient for the early detection of EGC during the first 65 months.

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幽门螺杆菌根除后短时间内密切随访有助于胃癌的早期发现。

前言:本研究的目的是优化幽门螺杆菌(HP)根除后早期胃癌(EGC)的监测频率和周期，以便有效发现EGC。方法:从2016年1月至2021年3月两家机构的内窥镜数据库中提取根除HP感染患者的数据。将患者分为根除后频繁监测的密切随访组和间歇性监测的开放随访组，分析两组根除后发现的EGC病例。结果:封闭随访组9322例患者中有36例(0.39%)，开放随访组11436例患者中有20例(0.17%)发现EGC。密切随访组根除后EGC的累计发病率显著高于对照组(p = 0.004)。密切随访组从根除到检测到EGC的时间明显缩短(51.7个月vs 90.5个月，p = 0.002)。逻辑回归模型显示，根除后的持续时间是密切随访组检测EGC的独立预测因子(p = 0.045)。Cox比例风险模型显示，密切随访策略在根除时间小于65个月的患者中识别EGC有效(p = 0.015)，但在根除时间大于65个月的患者中，两种策略无差异(p = 0.624)。讨论/结论:在HP根除后的前65个月内，频繁监测对于早期发现EGC是有效的。

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

Digestion 医学-胃肠肝病学

CiteScore

7.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.