Background: Since gastric cancers (GCs) detected afterHelicobacter pylori(HP) eradication present with different morphological characteristics from conventionalHP-positive GCs, delayed detection of early-stage GCs may be observed. This study aimed to investigate the clinical impact ofHPeradication on diagnosing GC during screening endoscopy. Methods: Eleven health checkup institutions in Japan participated in the present study. All GC cases newly diagnosed by screening endoscopy between January 2016 and December 2020 were included. After propensity score matching, multivariable regression analysis was performed to estimate the effect ofHPeradication on deep tumor invasion amongHP-eradicated andHP-positive GC cases. Results: A total of 231 patients with GCs (134HP-eradicated and 97HP-positive cases) were enrolled. After propensity score matching, there were 81 cases in each group. The distribution of the depth of tumor invasion (pT1a, pT1b1, pT1b2, and pT2) between theHP-eradicated group andHP-positive group was similar (p= 0.82). In the propensity analysis, withHP-positive as the reference value,HPeradication was not significantly associated with T1b–T4-GCs and T1b2–T4-GCs, with odds ratios (95% confidence intervals) of 1.16 (0.48–2.81) and 1.16 (0.42–3.19), respectively. Conclusions:HPeradication does not adversely affect the clinical course of GCs, supporting the recommendation ofHPeradication in screening programs to reduce the total number of GC cases without delaying diagnosis.
背景：由于根除幽门螺杆菌（HP）后检出的胃癌（GC）在形态学特征上与传统HP阳性胃癌存在差异，可能导致早期胃癌的延迟诊断。本研究旨在探讨HP根除对筛查内镜诊断胃癌的临床影响。方法：日本11家健康体检机构参与本研究，纳入2016年1月至2020年12月期间经筛查内镜新诊断的所有胃癌病例。通过倾向评分匹配后，采用多变量回归分析评估HP根除状态对肿瘤深部浸润的影响。结果：共纳入231例胃癌患者（HP根除组134例，HP阳性组97例）。经倾向评分匹配后，两组各保留81例病例。HP根除组与HP阳性组在肿瘤浸润深度（pT1a、pT1b1、pT1b2及pT2）的分布上无显著差异（p=0.82）。倾向性分析显示，以HP阳性组为参照，HP根除状态与T1b–T4期胃癌（比值比1.16，95%置信区间0.48–2.81）及T1b2–T4期胃癌（比值比1.16，95%置信区间0.42–3.19）均无显著相关性。结论：HP根除不会对胃癌临床病程产生负面影响，这支持在筛查项目中推荐HP根除治疗，可在不延误诊断的前提下有效降低胃癌总体发病率。
肿瘤(癌症)患者之家