The effect of Helicobacter pylori eradication on development of metachronous gastric cancer after endoscopic submucosal dissection of elderly patients with early gastric cancer
10.3760/cma.j.issn.0254-9026.2023.02.007
- VernacularTitle:幽门螺旋杆菌根除对老年早期胃癌患者内镜黏膜下剥离术后异时性癌的影响
- Author:
Zhenzhen XU
1
;
Jingwei JIANG
;
Ximei REN
;
Wen LI
;
Hua YANG
;
Yufang TENG
;
Xiangyu CHEN
;
Guifang XU
Author Information
1. 南京大学医学院附属鼓楼医院消化内科，南京 210008
- Keywords:
Helicobacter pylori;
Stomach neoplasms;
Metachronous gastric cancer
- From:
Chinese Journal of Geriatrics
2023;42(2):176-181
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of Helicobacter pylori(HP)eradication on development of metachronous gastric cancer(MGC)after endoscopic submucosal dissection(ESD)in elderly patients with early gastric cancer.Methods:From January 2014 to December 2019, 748 early gastric cancer patients aged 60 years or older, receiving ESD in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, were included.According to the situation of HP infection and eradication efficacy within 1 year postoperatively, patients were divided into three groups.The patients with HP infection and successful HP-eradication were enrolled into successful eradication group, those without eradicating or with eradication failure were enrolled into eradication failure group, those with HP negative were enrolled into HP-negative group.And then the occurrence and risk factors of MGC after ESD among the three groups were statistically analyzed.Results:MGC were detected in 58 cases(7.7%)in elderly patients with early gastric cancer after ESD.The median follow-up time was 39 months.The multivariate regression analysis results of MGC showed that no HP-eradication or HP eradication of failure( HR=2.231, 95% CI: 1.054-4.722, P=0.036)and multiple lesions( HR=1.857, 95% CI: 1.076-3.204, P=0.026)were independent risk factors.Non-smoking was a protective factor for the occurrence of MGC( HR=0.409, 95% CI: 0.234-0.716, P=0.002). After adjusting for confounding factors, Cox proportional risk regression analysis showed that the incidence of MGC was significantly higher in group of no HP-eradicating or HP-eradicating of failure than in group of successful HP-eradicating group( χ2=37.877, P<0.001). Conclusions:HP eradication can effectively prevent MGC in elderly patients with early gastric cancer after ESD.Multiple lesions and smoking are independent risk factors for MGC.
