Helicobacter Pylori and Gastric Precancerous Lesions: An update

  • Ibrahim Koral Onal Gazi University Medical School
  • Mevlut Kurt Abant Izzet Baysal University Medical School
  • Nasser Alizadeh Gazi University Medcal School
  • Fatih Saygili Turkiye Yuksek Ihtisas Education and Research Hospital
  • Mehmet Ibis Gazi University Medcal School
  • Ramazan Yildiz Gazi University Medcal School
Keywords: Atrophic gastritis, gastric cancer, Helicobacter Pylori, metaplasia, prevention, precancerous conditions

Abstract

Gastric cancer (GC) develops through a multistep process known as the gastritis-atrophy-metaplasia-dysplasia-cancer sequence associated with alterations in the expression of host oncogenes and tumor suppressor genes after several decades. Helicobacter pylori (H. pylori) infection is the most consistent risk factor for GC, and its elimination is, therefore, the most promising strategy to reduce the incidence of this malignant disorder. However, the results of the relevant studies are controversial as to whether the H. Pylori eradication effectively induces the regression of gastric preneoplastic lesions. The inconsistencies are likely due to the heterogeneity in studies with respect to the number of biopsy samples taken, the method of histologic classification of findings, sample size, and the duration of the follow-up. Additionally some probable or well-defined factors other than H. Pylori may influence the progression of gastric preneoplastic lesions. Lastly, the real existence of a “point of no return” may partially explain the controversial findings. Here, we present an index case, and review data about the role of H. pylori during gastric carcinogenesis, and subsequently discuss information available from recent studies to evaluate the benefit of the H. pylori eradication for the regression of gastric precancerous lesions.

Author Biographies

Ibrahim Koral Onal, Gazi University Medical School
Gastroenterology, Assoc Prof
Mevlut Kurt, Abant Izzet Baysal University Medical School
Gastroenterology, Assoc Prof
Nasser Alizadeh, Gazi University Medcal School
Gastroenterology, fellow
Fatih Saygili, Turkiye Yuksek Ihtisas Education and Research Hospital
Gastroenterology, fellow
Mehmet Ibis, Gazi University Medcal School
Gastroenterology, Assoc Prof
Ramazan Yildiz, Gazi University Medcal School
Medical Oncology, Assoc Prof

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Published
2015-07-02
Section
Literature Review With Cases