Helicobacter pylori eradication for the gastric cancer prevention

Kim, Jin Il

Abstract

It is well known that the Helicobacter pylori (H. pylori) infection is one of the major causes of gastric cancer development. It can be the remarkable point in cancer prevention strategies, if one-week antibiotic therapy for H. pylori prevents the gastric carcinogenesis. Since the WHO had classified H. pylori as the type I carcinogen for gastric cancer in 1994, academic efforts to investigate whether the treatment of H. pylori infection can prevent gastric carcinogenesis or not have made continuously, however, they have failed to make sufficient evidences despite 15 years of work. In gastric carcinogenesis, a variety of factors is involved. These include specific toxic factors of H. pylori. Subjects with specific genetic polymorphisms associated with gastric carcinogenesis are known to be at high risk for gastric cancer development and dietary environment such as high salt food and nitrogen compound also increase the risk of gastric cancer. H. pylori is involved in the transition from normal mucosa to chronic gastritis. Chronic atrophic gastritis can progress to intestinal metaplasia, dysplasia and finally to adenocarcinoma. And reversibility is lost after the progression to intestinal metaplasia and dysplasia. Therefore, H. pylori eradication dose not simply grantee the prevention of gastric carcinogenesis. We expect that the eradication of H. pylori before the stage of irreversible changes can do preventive effect. And further researches about virulent factors, genetic polymorphism, and other possible environmental conditions related to gastric carcinogenesis are crucial part in establishing preventive strategies for gastric cancer.