Treating H. pylori may not prevent gastric CA in background mucosa

Last Updated: 2016-01-14

By Lorraine L. Janeczko

NEW YORK (Reuters Health)  Treatment for Helicobacter pylori may not prevent metachronous gastric cancer in the background mucosa of patients with intestinal metaplasia (IM), a new paper suggests.

The authors base their conclusions on their finding that H. pylori eradication did not produce significant changes in the molecular alterations related to carcinogenesis.

Dr. Kiron M. Das of the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues first clarified the molecular markers related to carcinogenesis in IM in a cross-sectional study of 131 patients who underwent endoscopic resection for gastric neoplasia, as well as a control group of 22 chronic gastritis patients.

They evaluated MSI (microsatellite instability), the methylation status at the hMLH1, CDKN2A and APC genes, and immunoreactivity using the monoclonal antibody (mAb) Das-1.

Compared with the control group, MSI and mAb Das-1 reactivity showed significantly higher incidences in the H. pylori-positive and -negative groups, suggesting that MSI and mAb Das-1 reactivity are associated with gastric neoplasia (odds ratio for MSI 5.06; OR for mAb Das-1 reactivity 2.51).

Then, they characterized the changes of those markers at one year in 19 H. pylori-eradicated patients and 17 non-eradicated patients who had participated in a randomized trial of H. pylori treatment.

As reported online December 15 in the British Journal of Cancer, H. pylori eradication did not significantly reverse any molecular alterations, including MSI, the primary endpoint, and other methylation statuses and mAb Das-1 reactivity, the secondary endpoints.

"We are planning further study to identify the phenotype of IM, particularly colonic phenotype reactive to the mAb Das-1, which may allow early identification of high-risk patients," Dr. Das said in an email.

This study was supported by a grant-in-aid for researchers at Hyogo College of Medicine in Nishinomiya, Japan, and a research grant from the National Institute of Diabetes and Digestive and Kidney Disease.

SOURCE: http://bit.ly/1N9Uv6O

Br J Cancer 2015.