Korean J Gastroenterol.  2015 Dec;66(6):303-311. 10.4166/kjg.2015.66.6.303.

Unpleasant Journey from Helicobacter pylori-associated Gastritis to Gastric Cancer: Cancer Prevention by Taking a Detour

• Lee SH
• Park JM
• Han YM
• Ko WJ
• Hahm KB

• KMID: 2373363
• DOI: http://doi.org/10.4166/kjg.2015.66.6.303

Abstract

As a commensal or a pathogen, Helicobacter pylori can change the balance of a complex interaction that exists among gastric epithelial cells, microbes, and their environment. Therefore, unraveling this complex relationship of these mixtures can be expected to help prevent cancer as well as troublesome unmet medical needs of H. pylori infection. Though gastric carcinogenesis is a multi-step process, precancerous lesion can be reversible in the early phase of mucosal damage before reaching the stage of no return. However, biomarkers to predict rejuvenation of precancerous atrophic gastritis have not been identified yet and gastric cancer prevention is still regarded as an impregnable fortress. However, when we take the journey from H. pylori-associated gastritis to gastric cancer, it provides us with the clue for prevention since there are two main preventive strategies: eradication and anti-inflammation. The evidence supporting the former strategy is now ongoing in Japan through a nation-wide effort to eradicate H. pylori in patients with chronic gastritis, but suboptimal apprehension to increasing H. pylori resistance to antibiotics and patient non-compliance still exists. The latter strategy has been continued in the author's research center under siTRP (short-term intervention to revert premalignant lesion) strategy. By focusing on the role of inflammation in the development of H. pylori-associated gastric carcinogenesis, this review is intended to explain the connection between inflammation and gastric cancer. Strategies on H. pylori eradication, removal of inflammation, and reverting preneoplastic lesion will also be introduced. In the end, we expect to be able to prevent gastric cancer by take a detour from the unpleasant journey, i.e. from H. pylori-associated gastritis to gastric cancer.

Keyword

Helicobacter pylori; Inflammation; Nutrition therapy; Gastrointestinal cancer; Rejuvenation

MeSH Terms

Animals
Anti-Bacterial Agents/pharmacology/therapeutic use
Biomarkers/metabolism
Disease Models, Animal
Gastritis/*etiology
Helicobacter Infections/*complications/drug therapy
Helicobacter pylori/drug effects/metabolism/physiology
Humans
Stomach Neoplasms/etiology/*prevention & control
Virulence Factors/metabolism
Anti-Bacterial Agents
Biomarkers
Virulence Factors