Helicobacter pylori in gastric cancer: Features of infection and their correlations with long-term results of treatment

ARTICLE HIGHLIGHTS

Research background

Gastric cancer (GC) continues to be one of the most common malignant diseases in the world. It is known that Helicobacter pylori (H. pylori) infection, initiating the development of a chronic inflammatory process in the gastric mucosa (GM), is the leading risk factor for GC. At the same time, clinical studies indicate that inflammatory infiltration of the tumor stroma and surrounding tissues can have an important prognostic value and affect the long-term results of malignant neoplasm treatment.

Research motivation

It is still not clear whether H. pylori is involved only in the initiation of the tumor process in the stomach, or whether it can affect the mechanisms of tumor progression.

Research objectives

The aim of this study was to establish the features of H. pylori infection in patients with GC and their correlations with clinical and morphological characteristics of diseases and long-term results of treatment.

Research methods

In this prospective observational study, we included all patients with GC who had undergone radical surgery (R0) between May 2007 and March 2010 at the Orenburg Regional Clinical Oncology Center. Features of the H. pylori infection and its severity was determined by rapid urease test and by immunohistochemically using the antibody to H. pylori. The data obtained we compared with clinical features of GC: Stage, localization, histology, the presence of antibiotic therapy (AT) before surgery, and 10-year overall and disease-free survival.

Research results

We found H. pylori infection in the adjacent to the tumor GM in 84.5% of cases. We have established that the coccoid forms of H. pylori predominate in the GM of patients with GC. A high rate of infection by coccoid forms of H. pylori has been associated with more aggressive type of GC, advanced stage, and decline of a 10-year overall and disease-free survival. The presence of AT 1-1.5 mo before the operation was associated with an improvement in the 10-year survival rate of patients with local (T1-3N0M0), but not advanced (T3-4N1-2M0) stages of GC.

Research conclusions

These results indicate that H. pylori may be associated not only with induction but also with the progression of GC.

Research perspectives

The results obtained do not allow one to draw unambiguous conclusions about the role of H. pylori in the progression of GC. Further appropriate prospective studies regarding the role of H. pylori in the progression of GC are obviously advisable.