title: Helicobacter pylori infection and development of gastric cancer in Korea: long-term follow-up.
abstract: OBJECTIVE
  Infection of Helicobacter pylori is viewed as a major driver of progression to the precancerous state or to gastric cancer. This study was performed to investigate the effect of H. pylori infection on gastric cancer development and to determine to what extent H. pylori eradication is likely to reduce the prevalence of gastric cancer.
  
  
  METHODS
  Gastric cancer development was investigated in 1790 Korean subjects who underwent gastroscopy and H. pylori testing between 1992 and 1998. The effects of H. pylori-positive and eradicated states on gastric cancer development were analyzed.
  
  
  RESULTS
  Gastric cancer developed in 5 of the study cohort during a mean follow-up period of 9.4 years. All of these patients were positive for H. pylori infection, and 4 of the 5 had antral intestinal metaplasia (IM) at the time of study enrollment. One of these 5 patients was in an eradicated state when the gastric cancer was diagnosed, and had histologic IM before eradication therapy was performed. Gastric cancer was found to develop 10.9 times more frequently in the presence of IM than in its absence.
  
  
  CONCLUSIONS
  The present study shows a close relationship between H. pylori infection and IM, and between IM and the development of gastric cancer. In addition, our finding suggests that chronic H. pylori infection looks like an important risk factor for the development of gastric cancer in Korea, where the prevalence of H. pylori remains high. This study indicates that to prevent gastric cancer H. pylori eradication is best performed before the development of IM.
authors.affiliation: Departments of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea. nayoungkim49@empal.com
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Ran Young
authors.initials: RY
authors.lastname: Park
authors.forename: Sung-Il
authors.initials: SI
authors.lastname: Cho
authors.forename: Seon Hee
authors.initials: SH
authors.lastname: Lim
authors.forename: Kye Heui
authors.initials: KH
authors.lastname: Lee
authors.forename: Wooseung
authors.initials: W
authors.lastname: Lee
authors.forename: Hyung Min
authors.initials: HM
authors.lastname: Kang
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Lee
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
authors.forename: In Sung
authors.initials: IS
authors.lastname: Song
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D011230:Precancerous Conditions; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial