Hwang JJ, Lee DH, Kang KK, Lee AR, Yoon H, Shin CM, Park YS, Kim N. Eradication rate and histological changes after Helicobacter pylori eradication treatment in gastric cancer patients following subtotal gastrectomy. World J Gastroenterol 2015; 21(13): 3936-3943 [PMID: 25852279 DOI: 10.3748/wjg.v21.i13.3936]
Corresponding Author of This Article
Dong Ho Lee, MD, Department of Internal Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do 463-707, South Korea. dhljohn@yahoo.co.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 7, 2015; 21(13): 3936-3943 Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3936
Table 1 Baseline demographic and clinical characteristics of patients and univariate analysis of clinical factors influencing the eradication rate n (%)
Eradication success(n = 290)
Eradication failure(n = 36)
P value
Univariate analysis
Age
56.7 ± 10.4
56.9 ± 10.7
0.124
0.127
Gender
0.229
0.233
Male
183 (63.1)
19 (52.7)
Female
107 (36.9)
17 (47.3)
Smoking
0.789
0.792
Non-smoker
228 (78.6)
29 (80.5)
Smoker
62 (21.4)
7 (19.5)
Alcohol
0.213
0.219
Non-drinker
224 (77.2)
23 (63.8)
Drinker
66 (22.8)
13 (36.2)
Underlying disease
Hypertension
65 (22.4)
6 (16.6)
0.431
0.437
Diabetes mellitus
24 (8.2)
4 (11.1)
0.531
0.539
EGC/AGC
0.451
0.463
EGC
217 (74.8)
29 (80.5)
AGC
73 (25.2)
7 (19.5)
Tumor location
0.695
0.707
Lower (Antrum)
147 (50.6)
17 (47.2)
Middle (Body)
143 (49.3)
19 (52.7)
Surgery
0.012
0.016
Billroth-I
201 (69.4)
33 (91.7)
Billroth-II
89 (30.6)
3 (8.3)
Table 2H. pylori eradication rates of first- and second-line therapy
First-line therapy
Second-line therapy
P value
ITT analysis
%, Eradication(ratio)
78.4 (458/584)
90 (36/40)
0.027
95%CI
74.9-81.6
77.0-96.0
PP analysis
%, Eradication(ratio)
85.3 (458/530)
92.3 (36/39)
0.034
95%CI
82.1-88.1
79.7-97.4
Table 3 Multivariate analysis for the clinical factors related to the eradication success in the eradication success group
Odds ratio
95%CI
P value
Billroth-II vs Billroth-I
1.53
1.41-1.65
0.021
Male vs female
1.01
0.87-1.15
0.125
Smoking (+) vs (-)
1.07
0.89-1.25
0.163
Alcohol (+) vs (-)
0.98
0.94-1.08
0.187
Table 4 Histological changes of gastric mucosa according to eradication
Eradication success (n = 290)
Eradication failure (n = 36)
P value
Baseline
12 mo
P value
Baseline
12 mo
P value
Atrophy
0.46 ± 0.04
0.25 ± 0.04
< 0.001
0.50 ± 0.11
0.47 ± 0.12
0.698
0.023
IM
0.41 ± 0.05
0.27 ± 0.04
< 0.001
0.56 ± 0.14
0.51 ± 0.12
0.226
0.015
Neutrophil count
2.12 ± 0.04
0.40 ± 0.04
< 0.001
2.08 ± 0.12
1.11 ± 0.18
< 0.001
< 0.001
Mononuclear cells
2.10 ± 0.03
1.45 ± 0.03
< 0.001
2.08 ± 0.08
1.64 ± 0.11
0.004
0.085
Table 5 Comparison of histological changes of gastric mucosa in metachronous cancer patients (n = 7)
Baseline
12 mo
P value
Atrophy
1.29 ± 0.42
0.71 ± 0.36
0.436
Intestinal metaplasia
1.34 ± 0.41
1.00 ± 0.38
0.457
Neutrophil count
2.00 ± 0.22
0.86 ± 0.34
0.071
Mononuclear cell
2.00 ± 0.31
1.85 ± 0.20
0.289
Table 6 Histological changes of gastric mucosa according to reconstruction surgery after successful eradication
Billroth-I (n = 201)
Billroth-II (n = 89)
P value
Baseline
12 mo
P value
Baseline
12 mo
P value
Atrophy
0.33 ± 0.10
0.31 ± 0.12
0.831
0.53 ± 0.19
0.13 ± 0.09
< 0.001
0.029
IM
0.39 ± 0.13
0.37 ± 0.13
0.572
0.67 ± 0.21
0.32 ± 0.24
< 0.001
0.034
Neutrophil count
2.24 ± 0.10
0.21 ± 0.08
< 0.001
2.33 ± 0.16
0.33 ± 0.16
< 0.001
< 0.001
Mononuclear cells
2.21 ± 0.10
1.33 ± 0.12
0.831
1.93 ± 0.19
1.47 ± 0.09
0.540
0.085
Citation: Hwang JJ, Lee DH, Kang KK, Lee AR, Yoon H, Shin CM, Park YS, Kim N. Eradication rate and histological changes after Helicobacter pylori eradication treatment in gastric cancer patients following subtotal gastrectomy. World J Gastroenterol 2015; 21(13): 3936-3943