儿童幽门螺杆菌感染相关胃肿瘤前病变的全球患病率:一项系统综述和荟萃分析

IF 4.3 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Helicobacter Pub Date : 2025-02-28 DOI:10.1111/hel.70021
Mohammed Awadh Abdun, Lu Xu, Xiao-Ting Li, Amr Mekky, Maher Al Hussan, Ezaldin M. I. Abuheit, Chen Zhang, Ishtiaq Ur Rahman, Miao Yu, Hafiz Muhammad Sohail Sarwar, Bin-Bin Yan, Jia-Bei Xie, Bo-Wei Liu, Song-Ze Ding
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引用次数: 0

摘要

背景幽门螺杆菌(h.p ylori)是成人胃粘膜癌前病变的主要原因,但其对儿科患者的影响尚不清楚。我们旨在调查幽门螺旋杆菌引起的全球儿童和青少年胃癌前病变,并分析其影响因素,以便进行相关疾病的管理和预防。材料和方法我们在主要数据库中进行了全面的文献检索,以确定包括胃癌前病变和幽门螺杆菌感染状态的儿科患者的研究。使用随机效应或固定效应模型计算患病率。根据地理位置、年龄、全民健康覆盖(UHC)和出版时间进行分层分析。结果在筛选的3359篇相关文献中,24篇研究(7036名受试者)符合纳入标准。幽门螺杆菌感染患者癌前病变的总体患病率为17.2%,其中萎缩性胃炎(AG)和肠化生(IM)分别为13.5%和3.6%。不同地区感染个体的癌前病变率如下:非洲为33.8% (AG: 32.6%),拉丁美洲为22.1% (AG: 17.9%, IM: 4.0%),亚洲为18.1% (AG: 12.4%, IM: 4.4%,不典型增生:1.2%),欧洲为6.3% (AG: 4.3%, IM: 1.7%)。受感染的青少年(≤10岁)的癌前病变患病率高于年幼儿童(≤10岁),分别为14.2% (AG: 9.7%, IM: 2.9%)和3.4% (AG: 2.3%, IM: 1.1%)。中低UHC地区感染患者的癌前病变患病率高于高UHC地区(24.0%对12.5%)。结论幽门螺旋杆菌感染可导致儿童患者胃粘膜癌前病变,这是该人群关注的主要问题,也是一个以前被忽视的领域。未来有必要对相关疾病的预防进行深入调查和适当管理。试验注册号:CRD42023424683
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Global Prevalence of Helicobacter pylori Infection-Associated Gastric Preneoplastic Lesions in Pediatric Patients: A Systematic Review and Meta-Analysis

Background

Helicobacter pylori (H. pylori) is the major cause of gastric mucosal precancerous lesions in adulthood, but its impact on pediatric patients remains unclear. We aimed to investigate H. pylori-induced gastric precancerous lesions in children and adolescents globally and analyze their influencing factors for related disease management and prevention.

Materials and Methods

We conducted a comprehensive literature search in major databases to identify studies including pediatric patients with gastric precancerous lesions and H. pylori infection status. Prevalence rates were computed using random-effects or fixed-effect models. A stratified analysis was conducted based on location, age, universal health coverage (UHC), and publication time.

Results

Among the 3359 relevant articles screened, 24 studies (7036 participants) met the inclusion criteria. The overall prevalence of precancerous lesions in H. pylori-infected patients was 17.2%, in which atrophic gastritis (AG) and intestinal metaplasia (IM) were 13.5% and 3.6%, respectively. Precancerous lesion rates in infected individuals across different regions were as follows: Africa at 33.8% (AG: 32.6%), Latin America at 22.1% (AG: 17.9%, IM: 4.0%), Asia at 18.1% (AG: 12.4%, IM: 4.4%, Dysplasia: 1.2%), and Europe at 6.3% (AG: 4.3%, IM: 1.7%). Infected adolescents (> 10 years) exhibited a higher prevalence of precancerous lesions than younger children (≤ 10 years) at 14.2% (AG: 9.7%, IM: 2.9%) versus 3.4% (AG: 2.3%, IM: 1.1%), respectively. The prevalence of precancerous lesions in infected patients was higher in areas with low-medium UHC compared with high UHC (24.0% vs. 12.5%).

Conclusions

H. pylori infection causes significant gastric mucosal precancerous lesions in pediatric patients, representing a major concern for this population and a previously neglected area. Future in-depth investigations and proper management for related disease prevention are warranted.

Trial Registration

 PROSPERO number: CRD42023424683

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来源期刊
Helicobacter
Helicobacter 医学-微生物学
CiteScore
8.40
自引率
9.10%
发文量
76
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.
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