Association of Helicobacter pylori infection with esophageal adenocarcinoma and squamous cell carcinoma: a meta-analysis. Issue 7 (1st October 2014)

• Record Type: Journal Article
• Authors: Nie, S.; Chen, T.; Yang, X.; Huai, P.; Lu, M.
• Is Part Of: Diseases of the esophagus. Volume 27:Issue 7(2014)
• Page Start: 645
• Page End: 653
• Publication Date: 2014-10-01
• Subjects: esophageal adenocarcinoma -- esophageal squamous cell carcinoma -- Helicobacter pylori -- meta-analysis; Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1111/dote.12194
• Languages: English
• ISSNs: 1120-8694

Abstract

Summary: To evaluate the relationship of H elicobacter pylori and cytotoxin-associated gene A (CagA ) positive strains with esophageal neoplasm, including esophageal adenocarcinoma (EAC ) and esophageal squamous cell carcinoma (ESCC ), the authors conducted a meta-analysis using a predefined protocol. P ubM ed, W eb of S cience, C hina biology medical literature database, W anfang, and C hina N ational K nowledge I nfrastructure were searched for relevant articles from the first available year to A pril 8, 2013. The fixed or random effect pooled measure was selected based on heterogeneity among studies, which was evaluated using Q test and the I 2 of H iggins and T hompson. Metaregression was used to explore the sources of between-study heterogeneity. Publication bias was analyzed by B egg's funnel plot and E gger's regression test. The association was assessed by odds ratio (OR ) with 95% confidence interval (CI ). A total of 28 eligible studies were included in the meta-analysis. There was a significant inverse association between H . pylori infection (pooled OR, 0.57; 95% CI, 0.44–0.73) and EAC ; CagA -positive H . pylori strains were less likely to be associated with EAC compared with CagA -negative strains (pooled OR, 0.64; 95% CI, 0.52–0.79). However, there was no statistically significant association between H . pylori /CagA -positive H . pylori strains infection and ESCC, and the pooled OR s were 1.16 (95% CI, 0.83–1.60) and 0.97 (95% CI, 0.79–1.19). But significant associations between CagA -positive H . pylori strains infection and ESCC risk were found in the stratified analysis of the study location (A sian and non-A sian), and the summary OR s were 0.74 (95% CI, 0.57–0.97) and 1.41 (95% CI, 1.02–1.94). H . pylori infection and CagA -positive strains are associated with decreased risk of EAC in the overall population. No significant association was found between H . pylori infection/CagA -positive strains and ESCC . But CagA -positive strains might have a positive association with ESCC in non-A sian population and an inverse association in A sian population.