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http://dx.doi.org/10.7314/APJCP.2014.15.22.9905

Risk of Gastric Cancer in Children with Helicobacter pylori Infection  

Cam, Sebahat (Department of Pediatrics, Division of Pediatric Gastroenterology, Istanbul Medeniyet University Medical School)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.22, 2014 , pp. 9905-9908 More about this Journal
Abstract
Background: Helicobacter pylori (H. pylori) is the most common chronic infectious agent in the stomach. Most importantly, it may lead to atrophy, metaplasia and cancer. The aim of this study was to investigate the incidence of H. pylori infection and to detect early mucosal changes that may lead to malignant degeneration in children. Materials and Methods: Children who underwent upper gastrointestinal endoscopy were included. Familial history of gastric cancer was noted. Endoscopic examinations were performed by a single pediatric gastroenterologist. A minimum of three biopsy samples were collected during endoscopy. The patients were accepted as H. pylori infected if results of biopsies and rapid urease test were both positive. Biopsies were evaluated for the presence and degree of chronic inflammation, the activity and severity of gastritis, glandular atrophy and intestinal metaplasia. Results: A total of 750 children (388 boys, 362 girls) were evaluated in our study, with a mean age of 10.1 years. A total of 390 patients (52%) were found to be infected with H. pylori. Among the H. pylori infected patients, 289 (74%) were diagnosed to have chronic superficial gastritis, 24 (6.2%) had gastric atrophy. Most strikingly, intestinal metaplasia was observed in 11 children, all were in the H. pylori positive group. There was no difference in the mean of age, gender and socioeconomic class between H. pylori infected and non-infected groups. The frequency of gastric cancer in family members (4 in number) was higher in patients with H. pylori infection. No gastric cancer case was reported from the parents of non-infected children. The worst biopsy parameters (atropy and metaplasia) were improved after H. pylori eradication on control endoscopy. Conclusions: The current study shows a higher prevalence of familial history of gastric cancer in H. pylori infected children. Intestinal metaplasia was also higher in the infected children. Eradication of H. pylori infection for this risk group may prevent subsequent development of gastric cancer.
Keywords
Children; endoscopy; gastric cancer; H. pylori; metaplasia; prevention;
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1 Al-Hussaini A, Alghamdi S, Alsaaran R, et al (2014). Gastric adenocarcinoma presenting with gastric outlet obstruction in a child. Case Rep Gastrointest Med, 1-4.
2 Alvarez MC, Ladeira MS, Scaletsky IC, et al (2013). Methylation pattern of THBS1, GATA-4, and HIC1 in pediatric and adult patients infected with Helicobacter pylori. Dig Dis Sci, 58, 2850-7.   DOI
3 Axon A (2014). Helicobacter pylori and public health. Helicobacter, 19, 68-73.   DOI
4 Campbell DI, Warren BF, Thomas JE,et al (2001). The African enigma: low prevalence of gastric atrophy, high prevalence of chronic inflammation in West African adults and children. Helicobacter, 6, 263-67.   DOI
5 Chaturvedi R, Asim M, Piazuelo MB, et al (2014). Activation of EGFR and ERBB2 by Helicobacter pylori results in survival of gastric epithelial cells with DNA damage. Gastroenterology, 146, 1739-51.   DOI
6 Correa P (1983).The gastric precancerous process. Cancer Surv, 2, 437-50.
7 Ertem D, Harmanci H, Pehlivanoglu E (2003). Helicobacter pylori infection in Turkish preschool and school children: role of socioeconomic factors and breast feeding. Turk J Pediatr, 45, 114-22.
8 Everhart JE (2000). Recent developments in the epidemiology of Helicobacter pylori. Gastroenterol Clin North Am, 29, 559-78.   DOI   ScienceOn
9 Ford AC, Forman D, Hunt RH,et al (2014). Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials. BMJ, 348, 1-13.
10 Goldthorn JF, Canizaro PC (1986). Gastrointestinal malignancies in infancy, childhood, and adolescence. Surg Clin North America, 66, 845-61.
11 Guang W, Czinn SJ, Blanchard TG, et al (2014). Genetic regulation of MUC1 expression by Helicobacter pylori in gastric cancer cells. Biochem Biophys Res Commun, 445, 145-50.   DOI
12 Hardbower DM, Peek RM Jr, Wilson KT (2014). At the Bench: Helicobacter pylori, dysregulated host responses, DNA damage, and gastric cancer. J Leukoc Biol, 96, 201-12.   DOI
13 IARC Working Group (1994). Schistosomes, liver flukes and Helicobacter pylori. IARC Working group on the evaluation of carcinogenic risks to humans. Lyon.7-14 June 1994. IARC Monogr Eval Carcinog Risks Hum, 61, 1-241.
14 Iwanczak B, Francavailla R (2014). Helicobacter pylori infection in pediatrics. Helicobacter, 19, 46-51.   DOI
15 Jemal A, Bray F, Center MM et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.   DOI
16 McMillan M, Mackay WG, Williams CL, et al (2011). Intrafamilial genotyping of Helicobacter pylori from faecal DNA. Gastroenterol Res Pract, 2011, 1-7.
17 Mourad-Baars P, Hussey S, Jones NL (2010). Helicobacter pylori infection and childhood. Helicobacter, 15, 53-9.
18 Ozturk Y, Buyukgebiz B, Arslan N et al (2003). Antral glandular atrophy and intestinal metaplasia in children with Helicobacter pylori infection. J Pediatr Gastroenterol Nutr, 37, 96-97.   DOI
19 Piazuelo MB, Correa P (2013). Gastric cancer: Overview. Colomb Med, 44, 192-201.
20 Schneider BG, Peng DF, Camargo MC, et al (2010). Promoter DNA hypermethylation in gastric biopsies from subjects at high and low risk for gastric cancer. Int J Cancer, 127, 2588-97.   DOI
21 Vandenplas Y (2001). The role of Helicobacter pylori in paediatrics. Curr Opin Infect Dis, 14, 315-21.   DOI
22 Vanderpas J, Bontems P, Miendje Deyi VY, et al (2014). Follow up of Helicobacter pylori infection in children over two decades (1998-2007):persistence, relapse and acquisition rates. Epidemiol Infect, 142, 767-75.   DOI
23 Yu Y, Su L, Wang X, et al (2014). Association between Helicobacter pylori infection and pathological changes in the gastric mucosa in Chinese children. Intern Med, 53, 83-8.   DOI