DOI QR코드

DOI QR Code

Effect of Helicobacter pylori eradication on the regression of gastric polyps in National Cancer Screening Program

  • Nam, Su Youn (Department of Gastroenterology, Center for Gastric Cancer, Kyungpook National University Medical Center) ;
  • Park, Bum Joon (Department of Internal Medicine, Center for Cancer Prevention & Detection, National Cancer Center) ;
  • Ryu, Kum Hei (Department of Internal Medicine, Center for Cancer Prevention & Detection, National Cancer Center) ;
  • Nam, Ji Hyung (Department of Internal Medicine, Center for Cancer Prevention & Detection, National Cancer Center)
  • Received : 2016.09.05
  • Accepted : 2016.11.01
  • Published : 2018.05.01

Abstract

Background/Aims: Western guidelines recommend Helicobacter pylori eradication in H. pylori-associated gastric polyps; however, there is no standard guideline in Korea. The aim of this study is to assess the effect of H. pylori eradication on the regression of gastric hyperplastic polyps in National Cancer Screening Cohort, representative of general population. Methods: Among participants in National Cancer Screening Program, subjects who had H. pylori positive gastric hyperplastic polyps less than 10 mm and underwent follow-up endoscopy and H. pylori testing were enrolled. The effect of H. pylori eradication on hyperplastic gastric polyps was estimated using odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 183 H. pylori infected subjects with hyperplastic polyp at baseline underwent follow-up endoscopy and H. pylori test after mean of 2.2 years. Successful H. pylori eradication markedly induced the disappearance of hyperplastic polyps comparing to non-eradication group (83.7% vs. 34.1%, p = 0.001). Successful eradication increased the possibility of disappearance of hyperplastic polyps (adjusted OR, 5.56; 95% CI, 2.63 to 11.11). Polyp size was inversely related with the disappearance of hyperplastic polyps (adjusted OR, 59; 95% CI, 0.48 to 0.71). Conclusions: Eradication of H. pylori infection may induce disappearance of gastric hyperplastic polyps in National Cancer Screening Cohort.

Keywords

References

  1. Carmack SW, Genta RM, Schuler CM, Saboorian MH. The current spectrum of gastric polyps: a 1-year national study of over 120,000 patients. Am J Gastroenterol 2009;104:1524-1532. https://doi.org/10.1038/ajg.2009.139
  2. Goddard AF, Badreldin R, Pritchard DM, Walker MM, Warren B; British Society of Gastroenterology. The management of gastric polyps. Gut 2010;59:1270-1276. https://doi.org/10.1136/gut.2009.182089
  3. Daibo M, Itabashi M, Hirota T. Malignant transformation of gastric hyperplastic polyps. Am J Gastroenterol 1987;82:1016-1025.
  4. Orlowska J, Pietrow D. Multifocal gastric carcinoma arising from hyperplastic and adenomatous polyps. Am J Gastroenterol 1990;85:1629-1634.
  5. Cristallini EG, Ascani S, Bolis GB. Association between histologic type of polyp and carcinoma in the stomach. Gastrointest Endosc 1992;38:481-484. https://doi.org/10.1016/S0016-5107(92)70481-7
  6. Orlowska J, Jarosz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol 1995;90:2152-2159.
  7. Ginsberg GG, Al-Kawas FH, Fleischer DE, Reilly HF, Benjamin SB. Gastric polyps: relationship of size and histology to cancer risk. Am J Gastroenterol 1996;91:714-717.
  8. Suzuki S, Ohkusa T, Shimoi K, Horiuchi T, Fujiki K, Takashimizu I. Disappearance of multiple hyperplastic polyps after the eradication of Helicobacter pylori. Gastrointest Endosc 1997;46:566-568. https://doi.org/10.1016/S0016-5107(97)70020-8
  9. Ohkusa T, Takashimizu I, Fujiki K, et al. Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori: a randomized, clinical trial. Ann Intern Med 1998;129:712-715. https://doi.org/10.7326/0003-4819-129-9-199811010-00006
  10. Kume K, Hirakoba M, Murata I, Yoshikawa I, Otsuki M. Disappearance of both MALT lymphoma and hyperplastic polyps in the stomach after eradication of Helicobacter pylori. Am J Gastroenterol 2001;96:2796-2797. https://doi.org/10.1111/j.1572-0241.2001.04143.x
  11. Ohkusa T, Miwa H, Hojo M, et al. Endoscopic, histological and serologic findings of gastric hyperplastic polyps after eradication of Helicobacter pylori: comparison between responder and non-responder cases. Digestion 2003;68:57-62. https://doi.org/10.1159/000074516
  12. Nam SY, Park BJ, Ryu KH, Nam JH. Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps. Eur J Gastroenterol Hepatol 2016;28:449-454.
  13. Lee KS, Oh DK, Han MA, et al. Gastric cancer screening in Korea: report on the national cancer screening program in 2008. Cancer Res Treat 2011;43:83-88. https://doi.org/10.4143/crt.2011.43.2.83
  14. Shaib YH, Rugge M, Graham DY, Genta RM. Management of gastric polyps: an endoscopy-based approach. Clin Gastroenterol Hepatol 2013;11:1374-1384. https://doi.org/10.1016/j.cgh.2013.03.019
  15. Nam SY, Ryu KH, Park BJ, Park S. Effects of Helicobacter pylori infection and its eradication on lipid profiles and cardiovascular diseases. Helicobacter 2015;20:125-132. https://doi.org/10.1111/hel.12182
  16. Ji F, Wang ZW, Ning JW, Wang QY, Chen JY, Li YM. Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori: a randomized, controlled trial. World J Gastroenterol 2006;12:1770-1773. https://doi.org/10.3748/wjg.v12.i11.1770
  17. ASGE Standards of Practice Committee, Sharaf RN, Shergill AK, et al. Endoscopic mucosal tissue sampling. Gastrointest Endosc 2013;78:216-224. https://doi.org/10.1016/j.gie.2013.04.167

Cited by

  1. Helicobacter pylori eradication in the treatment of gastric hyperplastic polyps: beyond National Health Insurance vol.33, pp.3, 2018, https://doi.org/10.3904/kjim.2018.122
  2. Change in Size of Gastric Hyperplastic Polyps after Helicobacter pylori Eradication: A Prospective Study vol.19, pp.4, 2018, https://doi.org/10.7704/kjhugr.2019.0004
  3. Can Helicobacter pylori Eradication Regress Gastric Hyperplastic Polyps? vol.19, pp.4, 2018, https://doi.org/10.7704/kjhugr.2019.0039
  4. Regression of a Large Hyperplastic Polyp after Helicobacter pylori Eradication Treatment vol.76, pp.1, 2018, https://doi.org/10.4166/kjg.2020.76.1.49
  5. Changes of Gastric Juice Microenvironment in Patients with Fundic Gland Polyp and Hyperplastic Polyp vol.88, pp.6, 2018, https://doi.org/10.1159/000516855
  6. Effect of Helicobacter pylori eradication on hyperplastic gastric polyps: A systematic review and meta‐analysis vol.26, pp.5, 2018, https://doi.org/10.1111/hel.12838