H. pylori infection and the development of gastric cancer (original) (raw)
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Clinicopathological Study of Gastric Carcinoma with Special Reference to Helicobacter pylori
Journal of Pure and Applied Microbiology
Gastric cancer (GC) is one of the most common malignancies. Although Helicobacter pylori (H. pylori) is being recognized as a Type I carcinogen for GC and primary gastric lymphoma (PGL), yet many studies especially from the Indian subcontinent do not show any such association. The aim of the study was to evaluate the clinicopathological characteristics of gastric adenocarcinoma and to determine the association of H. pylori infection. This prospective study included 50 cases of histologically proven gastric adenocarcinoma. A detailed clinical history, physical examination and upper gastrointestinal endoscopy were done in all the cases and mucosal biopsies were taken from the growth and the surrounding mucosa. Rapid urease test (RUT) was done to diagnose H. pylori infection. 50 patients of functional dyspepsia were taken as controls. GC was more common in males (70%). The maximum cases were recorded in elderly persons, mostly from 5 th to 6 th decades. Anorexia (60%), dyspepsia (54%) and weight loss (24%) were the commonest clinical presentation. Most of the patients presented within 3-12 month of onset of symptom. In majority of cases, the lesion was confined to the antrum (62%) and body (26%) of the stomach. H. pylori infection was more commonly isolated from the antrum. H. pylori infection was not significantly associated with GC as compared to patients with functional dyspepsia. No association was found between H. pylori infection and gastric carcinoma. Probably gastric cancer is multifactorial disease where dietary, genetic and environmental factors play contributing roles.
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.
Cancer Science, 2007
We used Helicobacter pylori sero-positivity and mucosal atrophy as detected by the serum pepsinogen method to identify H. pylori infection-negative gastric cancer patients with or without atrophy. One hundred and six of 748 (14.2%) primary gastric cancer patients were infection-negative by a serum antibody detection system. Further, 121 (16.2%) of the 748 were negative for gastric mucosal atrophy by the pepsinogen method, of whom 15/748 (2.0%) were H. pylori-negative by pepsinogen I level (> > > >70 ng/mL) and pepsinogen I/II ratio (> > > >3.0). Twenty-seven of 782 (3.6%) gastric cancer patients were H. pylori-negative by antibodies and severe atrophy as determined by pepsinogen I level (< < < <30 ng/mL) and pepsinogen I/II ratio (< < < <2.0). H. pylori-negative gastric cancer patients with severe atrophy likely had a previous infection. These results indicate that the actual number of H. pylori-negative patients is 2.0% at minimum and 10.6% (14.2% minus 3.6%) at maximum in the general Japanese population. Five of 15 (33%) cases displaying neither anti-H. pylori antibodies nor atrophy were intestinal-type and 10 (67%) were diffuse-type adenocarcinomas. Thirteen surgical patients with primary gastric cancer displaying neither antibodies nor mucosal atrophy were further analyzed for pathological and phenotypic characteristics. The mucin phenotype was divided into four gastric, five gastric and intestinal, two intestinal and two null types, independent of histological classification. Intestinal phenotype elements were detected by Cdx2 immunohistochemical methods in nine of 13 (70%) cases examined. We conclude that a small fraction of gastric cancer patients displayed multifactorial carcinogenesis without H. pylori infection, indicating that gastric cancer risk still exists in the absence of H. pylori infection, at an incidence of 2.0% at minimum and 10.6% at maximum in the general Japanese population. (Cancer Sci 2007; 98: 790-794)
Association of Helicobacter Pylori Infection and Gastric Cancer
Post-Graduate Medical Journal of NAMS, 2015
Introduction: Gastric cancer remains one of the most common cancers worldwide and the second leading cause of cancer mortality in the world. Helicobacter Pylori is a major risk factor. Early detection of infection and eradication therapy will probably reduce the incidence of stomach cancer. This study is carried out to see the association of the H. pylori infection in gastric cancer patients in our population. Methods: This is a prospective cross sectional descriptive study done in Gastroenterology unit, Department of medicine, National Academy of Medical Sciences, Bir Hospital. Patients who were suspected of cancer of stomach clinically as well as endoscopically,their thorough history was taken and demographic profiles like age, sex and geographic location were recorded. Similarly, symptoms, risk factors and endoscopic finding were recorded. Likewise, result of rapid urease test and histopathology results were documented. Results: Male patients were seen to be more frequently affec...