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Metachronous gastric cancer after successful Helicobacter pylori eradication.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2014 Sep 07; Vol. 20 (33), pp. 11552-9. - Publication Year :
- 2014
-
Abstract
- The high incidence of gastric cancer in Japan initially resulted in establishment of a country-wide gastric cancer screening program to detect early and treatable cancers. In 2013 countrywide Helicobacter pylori (H. pylori) eradication was approved coupled with endoscopy to assess for the presence of chronic gastritis. Current data support the notion that cure of the infection in those with non-atrophic gastritis will prevent development of gastric cancer. However, while progression to more severe damage is halted in those who have already developed, atrophic gastritis/gastric atrophy remain at risk for subsequent development of gastric cancer. That risk is directly related to the extent and severity of atrophic gastritis. Methods to stratify cancer risk include those based on endoscopic assessment of the atrophic border, histologic grading, and non-invasive methods based on serologic testing of pepsinogen levels. Continued surveillance is required because those with atrophic gastritis/gastric atrophy retain considerable gastric cancer risk even after H. pylori eradication. Those who have already experienced a resectable early gastric cancer are among those at highest risk as metachronous lesions are frequent even after H. pylori eradication. We review the role of H. pylori and effect of H. pylori eradication indicating the incidence and the predictive factors on development of metachronous cancer after endoscopic therapy of early gastric cancer. Studies to refine risk markers to stratify for risk, surveillance methods, intervals, and duration after successful H. pylori eradication, and whether adjuvant therapy would change risk are needed.
- Subjects :
- Biomarkers blood
Helicobacter Infections blood
Helicobacter Infections diagnosis
Helicobacter Infections epidemiology
Helicobacter Infections microbiology
Helicobacter pylori pathogenicity
Humans
Incidence
Japan epidemiology
Predictive Value of Tests
Risk Assessment
Risk Factors
Stomach Neoplasms blood
Stomach Neoplasms epidemiology
Stomach Neoplasms microbiology
Stomach Neoplasms pathology
Time Factors
Treatment Outcome
Anti-Bacterial Agents therapeutic use
Gastrectomy
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Neoplasms, Second Primary
Stomach Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 20
- Issue :
- 33
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 25206262
- Full Text :
- https://doi.org/10.3748/wjg.v20.i33.11552