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, 12 (2), e0170942
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Distinct Clinicopathological Features and Prognosis of Helicobacter Pylori Negative Gastric Cancer

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Distinct Clinicopathological Features and Prognosis of Helicobacter Pylori Negative Gastric Cancer

Kun-Feng Tsai et al. PLoS One.

Abstract

Background: Whether the characteristics and prognosis of gastric cancer (GC) are different in patients with and without Helicobacter pylori (HP) remains controversial. The definitions of HP status in patients with atrophic gastritis but negative tests for HP are heterogeneous. We aimed to assess the impact of HP on the prognosis of GC using different definitions.

Methods: From 1998 Nov to 2011 Jul, five hundred and sixty-seven consecutive patients with GC were included. HP status was determined by serology and histology. Patients with any positive test were defined as HP infection. Patients without HP infection whose serum pepsinogen (PG) I <70 ng/dl and PG I/II ratio < 3.0 were defined as atrophic gastritis and they were categorized into model 1: HP positive; model 2: HP negative; and model 3: exclusion of these patients.

Results: We found four characteristics of HP negative GC in comparison to HP positive GC: (1) higher proportion of the proximal tumor location (24.0%, P = 0.004), (2) more diffuse histologic type (56.1%, p = 0.008), (3) younger disease onset (58.02 years, p = 0.008) and (4) more stage IV disease (40.6%, p = 0.03). Patients with negative HP had worse overall survival (24.0% vs. 35.8%, p = 0.035). In Cox regression models, the negative HP status is an independent poor prognostic factor (HR: 1.34, CI:1.04-1.71, p = 0.019) in model 1, especially in stage I, II and III patients (HR: 1.62; CI:1.05-2.51,p = 0.026).

Conclusion: We found the distinct characteristics of HP negative GC. The prognosis of HP negative GC was poor.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Influence of H. pylori status on overall survival and relapse free survival.
Overall survival (a), relapse free survival (b).
Fig 2
Fig 2. Influence of H. pylori status on overall survival according to AJCC 7th stages.
stage I (a), stage II (b), stage III (c), stage IV (d).
Fig 3
Fig 3. Influence of H. pylori status on overall survival according to AJCC 7th stages.
stage II/III (a), stage II/IIIa/IIIb (b), stage II/IIIa(c).

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References

    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA-Cancer J Clin 2011;61:69–90. 10.3322/caac.20107 - DOI - PubMed
    1. Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Negri E, et al. Recent patterns in gastric cancer: A global overview. Int J Cancer 2009;125:666–673. 10.1002/ijc.24290 - DOI - PubMed
    1. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 2012;13:607–615. 10.1016/S1470-2045(12)70137-7 - DOI - PubMed
    1. Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroen Hepatol 2010;25:479–486. - PubMed
    1. Schlansky B, Sonnenberg A. Epidemiology of noncardia gastric adenocarcinoma in the United States. Am J Gastroenterol 2011;106:1978–1985. 10.1038/ajg.2011.213 - DOI - PubMed

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Grant support

The study was funded by the Ministry of Science and Technology, Executive Yuan, ROC, Taiwan (Grant Number: MOST 103-2314-B-002-154-MY2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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