Characteristic analysis of early gastric cancer after <i>Helicobacter pylori</i> eradication: a multicenter retrospective propensity score-matched study
Creators: name: Liu, Xinyuan
name: Wang, Xinyu
name: Mao, Tao
name: Yin, Xiaoyan
name: Wei, Zhi
name: Fu, Jindong
name: Wu, Jie
name: Li, Xiaoyu
Publisher: name: Taylor & Francis
Year: 2023
Subjects: subject: Biochemistry
subject: Space Science
subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Cell Biology
subject: Chemical Sciences not elsewhere classified
subject: Science Policy
subject: Immunology
subject: FOS: Clinical medicine
subject: Mathematical Sciences not elsewhere classified
subject: Cancer
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Computational Biology

description: <i>Helicobacter pylori</i> (<i>H. pylori</i>) is recognized as a type I carcinogen in gastric cancer (GC). However, GC still occurs after <i>H. pylori</i> eradication, and its diagnosis is more complicated. This study aimed to summarize the characteristics of early GC (EGC) after <i>H. pylori</i> eradication to help accurately identify EGC and avoid missed diagnosis and misdiagnosis. A total of 81 patients of EGC after <i>H. pylori</i> eradication (Hp-eradicated group), resected by endoscopic submucosal dissection (ESD), and 105 cases of <i>H. pylori</i> infection-related EGC (control group) were assessed. After propensity-score matching, the clinical characteristics, endoscopic manifestations, and histopathological features of the 62 matched patients in each group were analyzed. We also conducted specific analyses in combination with endoscopic and histopathological images. There were more patients in the Hp-eradicated group who received proton pump inhibitor (PPI) for &gt;1 year compared to the control group (<i>p</i> &lt; 0.001). More patients at OLGA stages I-II before the diagnosis of EGC were in the control group (<i>p</i> = 0.045), especially at stage II. The mucosa in the Hp-eradicated group showed more moderate-to-severe atrophy (<i>p</i> = 0.047), map-like redness (<i>p</i> &lt; 0.001) and mild activity (<i>p</i> &lt; 0.001). The predominant histopathological types differed between the two groups (<i>p</i> &lt; 0.001), and the majority of cases in the Hp-eradicated group were high-grade intraepithelial neoplasia (HGIN). Ki-67 expression was lower in the Hp-eradicated group (<i>p</i> = 0.025). But different eradication intervals of <i>H. pylori</i> have little effect on the characteristics of EGC. Furthermore, PPI uses for &gt;1 year (<i>p</i> = 0.005), mucosal map-like redness (<i>p</i> &lt; 0.001), moderate mucosal atrophy (<i>p</i> = 0.017), and mild activity of gastric mucosa (<i>p</i> = 0.005) were independent characteristics of EGC after <i>H. pylori</i> eradication. Our multicenter study revealed that EGC after <i>H. pylori</i> eradication was characterized by long-term PPI use, moderate mucosal atrophy, mucosal map-like redness, the mild activity of gastric mucosa, a higher proportion of HGIN cases, and lower levels of Ki-67. EGC after <i>H. pylori</i> eradication was characterized by long-term PPI use, moderate mucosal atrophy, mucosal map-like redness, mild activity of gastric mucosa, a higher proportion of HGIN cases, and lower levels of Ki-67.<i>H. pylori</i>-positive patients at OLGA stages I-II are also more likely to progress to EGC.According to the current data, different eradication intervals of <i>H. pylori</i> have little effect on the characteristics of EGC. EGC after <i>H. pylori</i> eradication was characterized by long-term PPI use, moderate mucosal atrophy, mucosal map-like redness, mild activity of gastric mucosa, a higher proportion of HGIN cases, and lower levels of Ki-67. <i>H. pylori</i>-positive patients at OLGA stages I-II are also more likely to progress to EGC. According to the current data, different eradication intervals of <i>H. pylori</i> have little effect on the characteristics of EGC.