Effect ofHelicobacter pyloriinfection and its eradication on gastric regenerating atypia in 22 133 subjects

Abstract

Background and Aim The aim of this study was to identify factors affecting persistent gastric regenerating atypia and determine the effect ofHelicobacter pylorieradication on the course of this lesion. Methods In cross-sectional setting, comprehensive health check-up subjects who underwent both endoscopy andH. pyloritest from 2001 to 2009 were included. The association betweenH. pyloriand gastric regenerating atypia was evaluated. In cohort setting, patients with regenerating atypia who underwentH. pyloritest from 2001 to 2013 were included. Factors affecting positive pathology (persistent regenerating atypia or new development of neoplasm) in patients with regenerating atypia at baseline were investigated. Results In cross-sectional setting, regenerating atypia was observed in 1.1% (241/22 133).H. pyloriinfection was associated with gastric regenerating atypia (adjusted odds ratio, 1.47; 95% confidence interval [CI], 1.12-1.91). In cohort setting, 310 patients with regenerating atypia were finally eligible. Positive pathology rate during follow up was 16.1% (15/93) in the persistent infection group, 2.8% (3/106) in successful eradication group, and 4.5% (5/111) in baselineH. pylori-negative group. PersistentH. pyloriinfection increased the risk of positive pathology (adjusted risk ratio [RR], 7.18; 95% CI, 1.95-26.48) compared toH. pylorieradication group. PersistentH. pyloriinfection increased the risk of regenerative atypia (adjusted RR, 5.70; 95% CI, 1.46-22.17) and new neoplasm (adjusted RR, 10.74; 95% CI, 1.10-105.17) compared to baseline negativeH. pylori. Conclusions H. pyloriinfection is an independent risk factor for gastric regenerating atypia. Eradication ofH. pyloriseems helpful for regression of regenerating atypia.