Role of Helicobacter pylori infection in gastric cancer pathogenesis: A chance for prevention (original) (raw)

H. pylori infection and gastric cancer: State of the art (Review)

2013

Gastric cancer (GC) is one of the leading types of cancer worldwide, particularly in East Asian populations. Helicobacter pylori (HP) infection has been established as a major risk factor for GC. Although more than 50% of the world population is infected with this bacterium, less than 2% develop GC. Therefore, further risk factors (such as host genetic polymorphisms and lifestyle, as well as environmental and epigenetic factors) may also play a role in its occurrence. The correlation between HP infection and GC represents a typical model of a multi-step process, characterized by some pre-neoplastic lesions with a high risk of progression (atrophic gastritis, intestinal metaplasia and dysplasia). In addition, HP also plays an oncogenic role in the development of mucosa-associated lymphoid tissue (MALT) lymphoma, that accounts for approximately 3% of all gastric tumors. Hyperplastic polyps often arise in patients with atrophic gastric mucosa and HP-associated gastritis (25% of cases); however, their malignant trasformation is rare (<3% of cases). A number of trials have demonstrated the possibility of cancer prevention through HP screening and eradication, particularly in high-risk populations, whereas it may not be cost-effective in areas of low risk. In this review, we discuss i) the complex pathogenetic mechanisms of gastric carcinogenesis in which HP is involved; ii) the main approaches to the diagnosis, prevention, surveillance and treatment of pre-malignant lesions associated with HP infection; iii) the most effective way to detect GC in its earlier stages; and iv) the most important contribution to reducing the burden of GC.

Helicobacter pylori and gastric cancer

The American Journal of Medicine, 1999

Helicobacter pylori (H. pylori) is one of the most common infectious diseases worldwide. There are data on the epidemiology, pathophysiology, and histology of this disease that show that H. pylori gastritis has an important role in gastric carcinogenesis. However, it has to be considered that only very few of those infected with H. pylori will develop gastric cancer. Hence, it will be a main target of future research to identify individuals who carry a greater risk for developing gastric cancer, and therefore may benefit from eradication of H. pylori in terms of gastric cancer prevention.

H pylori and gastric cancer: Shifting the global burden

2006

Infection with H pylori leads to a persistent chronic infl ammation of the gastric mucosa, thereby increasing the risk of distal gastric adenocarcinoma. Numerous studies have determined a clear correlation between H pylori infection and the risk of gastric cancer; however, general eradication is not recommended as cancer prophylaxis and time points for treatment remain controversial in different areas of

H. pylori infection and the development of gastric cancer

The Keio Journal of Medicine, 2002

BACKGROUND: Recently, many study have shown that Helicobacter pylori infection is crucial in development of atrophic gastritis, which is closely associated with gastric cancer. We con ducted a long-term endoscopic prospective follow-up study to investigate the development of gastric cancer in H. pylori-positive and-negative patients. METHODS: 1603 patients who underwent endos-copy and were assessed as to the presence of H. pylori infection by histology, rapid urease test and serologic test between April 1990 and March 1993 were entered. We prospectively studied 1246 sub jects with and 280 subjects without H. pylori infection for a mean follow-up of 7.8 years (range 1-10.6 years). RESULTS: Gastric cancer of both the intestinal and diffuse type developed in 36 (2.9%) infected patients but in none of the uninfected patients during follow-up. There was an increased risk for gastric cancer in infected patients with severe gastric atrophy and corpus predominant gastritis and intestinal metaplasia. Gastric cancer was detected in 21 (4.7%) of the patients with non ulcer dyspepsia, in 10 (3.4%) of those with gastric ulcer and in 5 (2.2%) of those with gastric hyperplastic polyp, at en rollment. No gastric cancer was detected in duodenal ulcer patients. CONCLUSION: These results suggest that the development of both types of gastric cancer is caused by H. pylori-associated gastritis, and the risk for development of gastric cancer in H. pylori-negative subjects is extremely low. Subjects having H. pylori-positive gastric mucosa with severe atrophy and/or corpus gastritis may be at partic ularly high risk for gastric cancer.

Helicobacter pylori infection and gastric carcinoma

Clinical Microbiology and Infection, 2015

Helicobacter pylori infection is considered to be the main cause of gastric cancer and the most frequent infection-induced cancer. H. pylori is a heterogeneous species which can harbour pathogenic factors such as a cytotoxin, a pathogenicity island (cag) encoding a type 4 secretion system, and the first bacterial oncoprotein, CagA. This oncoprotein appears to be involved in the carcinogenic process in addition to the inflammation generated. This process may concern either local progenitors via an epithelial-mesenchymal transition, or recruited bone marrow-derived mesenchymal cells. There are also environmental factors such as iron deficiency or high-salt diets which interact with the bacterial factors to increase the risk of gastric cancer as well as genetic polymorphism of certain cytokines, e.g. IL-Iβ. Recent data suggest that a break in coevolution of a particular phylogeographic lineage of H. pylori and its usual host may also be a risk factor. Studies are currently being performed to assess the feasibility of organized H. pylori eradication programmes to prevent gastric cancer.

Helicobacter pylori and the prevention of gastric cancer

Canadian journal of gastroenterology = Journal canadien de gastroenterologie, 2004

Helicobacter pylori is an important cause of stomach cancer that infects a substantial proportion of the Canadian adult population. H pylori can be detected by noninvasive tests and effectively eradicated by medical treatment. Screening for and treatment of H pylori may represent a significant opportunity for preventive oncology. Cancer Care Ontario organized a workshop held in Toronto, Ontario, on October 24 and 25, 2002, to: review the current state of knowledge regarding H pylori treatment and cancer prevention; determine if there is currently sufficient evidence to consider the promotion of H pylori treatment for the purpose of cancer prevention; identify critical areas for research; and advise Cancer Care Ontario on H pylori and cancer prevention. Workshop participants developed a number of recommendations for research into the relationship between H pylori and stomach cancer, including determining the prevalence of infection in different regions of Canada, the pathogenetic seq...