Histological changes of gastric mucosa after Helicobacter pylori eradication:a systematic review and meta-analysis

被引:14
作者
Yan-Jun Kong [1 ]
Hong-Gang Yi [2 ]
Jun-Cheng Dai [2 ]
Mu-Xin Wei [1 ,3 ,4 ]
机构
[1] Division of Traditional Chinese Medicine,the First Affiliated Hospital of Nanjing Medical University
[2] Division of Epidemiology,Nanjing Medical University School of Public Health
[3] National Institute for Physiological Sciences,Okazaki,Aichi 444-8585,Japan
[4] HiPep Laboratories,Kyoto 602-8158,Japan
关键词
Helicobacter pylori eradication; Gastric atrophy; Intestinal metaplasia; Pathological changes; Gastric mucosa; Meta-analysis;
D O I
暂无
中图分类号
R378 [病原细菌];
学科分类号
100103 ; 100705 ;
摘要
AIM:To systematically review pathological changes of gastric mucosa in gastric atrophy(GA)and intestinal metaplasia(IM)after Helicobacter pylori(H.pylori)eradication.METHODS:A systematic search was made of PubMed,Web of Science,EMBASE,ClinicalTrials.gov,OVID and the Cochran Library databases for articles published before March 2013 pertaining to H.pylori and gastric premalignant lesions.Relevant outcomes from articles included in the meta-analysis were combined using Review Manager 5.2 software.A Begg’s test was applied to test for publication bias using STATA 11software.χ2 and I2 analyses were used to assess heterogeneity.Analysis of data with no heterogeneity(P>0.1,I2<25%)was carried out with a fixed effects model,otherwise the causes of heterogeneity were first analyzed and then a random effects model was applied.RESULTS:The results of the meta-analysis showed that the pooled weighted mean difference(WMD)with 95%CI was 0.23(0.18-0.29)between eradication and non-eradication of H.pylori infection in antral IM with a significant overall effect(Z=8.19;P<0.00001)and no significant heterogeneity(χ2=27.54,I2=16%).The pooled WMD with 95%CI was-0.01(-0.04-0.02)for IM in the corpus with no overall effect(Z=0.66)or heterogeneity(χ2=14.87,I2=0%)(fixed effects model).In antral GA,the pooled WMD with 95%CI was 0.25(0.15-0.35)with a significant overall effect(Z=4.78;P<0.00001)and significant heterogeneity(χ2=86.12,I2=71%;P<0.00001).The pooled WMD with 95%CI for GA of the corpus was 0.14(0.04-0.24)with a significant overall effect(Z=2.67;P=0.008)and significant heterogeneity(χ2=44.79,I2=62%;P=0.0003)(random effects model).CONCLUSION:H.pylori eradication strongly correlates with improvement in IM in the antrum and GA in the corpus and antrum of the stomach.
引用
收藏
页码:5903 / 5911
页数:9
相关论文
共 24 条
[2]   A five-year follow-up study on the pathological changes of gastric mucosa after H.pylori eradication [J].
周丽雅 ;
沈祖尧 ;
林三仁 ;
金珠 ;
丁士刚 ;
黄雪彪 ;
夏志伟 ;
郭慧兰 ;
刘建军 ;
曹世植 .
Chinese Medical Journal, 2003, (01)
[3]  
Eradication of Helicobacter pylori infection improved gastric mucosal atrophy and prevented progression of intestinal metaplasia, especially in the elderly population: A long‐term prospective cohort study[J] . TatsuyaToyokawa,Kin‐ichiroSuwaki,YasuhiroMiyake,MorihitoNakatsu,MasaharuAndo.Journal of Gastroenterology and Hepatology . 2010 (3)
[4]   Helicobacter pylori and gastric cancer [J].
Suzuki, Hidekazu ;
Iwasaki, Eisuke ;
Hibi, Toshifumi .
GASTRIC CANCER, 2009, 12 (02) :79-87
[5]  
Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial[J] . Kazutoshi Fukase,Mototsugu Kato,Shogo Kikuchi,Kazuhiko Inoue,Naomi Uemura,Shiro Okamoto,Shuichi Terao,Kenji Amagai,Shunji Hayashi,Masahiro Asaka.The Lancet . 2008 (9636)
[6]  
The Long‐term Impact of Helicobacter?pylori Eradication on Gastric Histology: a Systematic Review and Meta‐analysis[J] . TheodorosRokkas,DimitiosPistiolas,PanosSechopoulos,IoannisRobotis,GeorgiosMargantinis.Helicobacter . 2007
[7]  
Helicobacter pylori eradication in the healing of atrophic gastritis: A one-year prospective study[J] . Scandinavian Journal of Gastroenterology . 2006 (7)
[8]  
Long‐term follow‐up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection[J] . E.LAHNER,C.BORDI,M. S.CATTARUZZA,C.IANNONI,M.MILIONE,G.DELLE FAVE,B.ANNIBALE.Alimentary Pharmacology & Therapeutics . 2005 (5)
[9]   A follow-up study on the effect of Helicobacter pylori eradication on the severity of gastric histology [J].
Salih, BA ;
Abasiyanik, MF ;
Saribasak, H ;
Huten, O ;
Sander, E .
DIGESTIVE DISEASES AND SCIENCES, 2005, 50 (08) :1517-1522
[10]   Influence of gastritis on cyclooxygenase-2 expression before and after eradication of Helicobacter pylori infection [J].
Wambura, C ;
Aoyama, N ;
Shirasaka, D ;
Kuroda, K ;
Maekawa, S ;
Ebara, S ;
Watanabe, Y ;
Tamura, T ;
Kasuga, M .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2004, 16 (10) :969-979