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Negative H. pylori status indicated poor prognosis in gastric cancer
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Researchers from Italy have found that negative Helicobacter pylori status was an independent indicator of poor prognosis among people with gastric cancer.
The researchers retrieved frozen, non-neoplastic gastric mucosa and serum samples from 297 patients who underwent surgery for primary gastric cancer between 1988 and 2004. Fifty-eight percent of the study population was men and 42% women. Mean age was 68 years.
Associations between clinicopathologic variables and long-term outcome were determined by univariate and multivariate analysis.
Results indicated that 86% of participants were positive for H. pylori infection. Polymerase chain reaction for the vacA gene and serological tests were negative among 14% of participants.
Cardia location, advanced pT classification, noncurative surgery and a lower five-year survival rate after R0 resection were all significantly associated with negative H. pylori status (P<.001). Patients without evidence of infection were more likely to have tumors located in the cardia and involved in the serosal layer.
When the researchers further categorized the participants into three groups (current infection, prior infection and never infected), they found a significant difference for patients with a current infection vs. those never infected (P=.001) and among those with a prior infection vs. those never infected (P=.016).
“While awaiting potential explanations of the mechanisms that affect the clinical outcome of people with gastric cancer, we confirm that in addition to other well-known clinicopathologic parameters, H. pylori status is a prognostic factor in gastric cancer,” the researchers wrote.
Marelli D. Cancer. 2009; doi:10.1002/cncr.24253.