title: Association betweenHelicobacter pyloristatus and metachronous gastric cancer after endoscopic resection.
abstract: OBJECTIVE
  To investigate the effect ofHelicobacter pylori(H. pylori) status test andH. pylorieradication on the occurrence of metachronous gastric cancer (MGC) after endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) and risk factors of MGC.
  
  
  METHODS
  The authors retrospectively reviewed the medical records of 433 patients (441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; theH. pyloritested group (n= 257) and theH. pylorinon-tested group (n= 176) based on performance ofH. pyloristatus test after ESD of EGC. TheH. pyloritested group was further categorized into three subgroups based onH. pyloristatus; theH. pylori-eradicated subgroup (n= 120), theH. pylori-persistent subgroup (n= 42), and theH. pylori-negative subgroup (n= 95). Incidences of MGC and risk factors of MGC were identified.
  
  
  RESULTS
  Median follow-up duration after ESD was 30.00 mo (range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of theH. pyloritested group (7 in theH. pylori-negative subgroup, 3 in theH. pylori-eradicated subgroup, and 1 in theH. pylori-persistent subgroup) and 4 patients of theH. pylorinon-tested group (P> 0.05). The risk factors of MGC were endoscopic mucosal atrophy in theH. pyloritested group and intestinal metaplasia in all patients.
  
  
  CONCLUSIONS
  H. pylorieradication andH. pyloristatus test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in theH. pyloritested group alone and intestinal metaplasia in all patients.
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Si Hyung
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Bae
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Yo Han
authors.initials: YH
authors.lastname: Jeong
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Sohn
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Kyeong Ok
authors.initials: KO
authors.lastname: Kim
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Jang
authors.affiliation: Sung Bum Kim, Si Hyung Lee, Seung Il Bae, Yo Han Jeong, Se Hoon Sohn, Kyeong Ok Kim, Byung Ik Jang, Tae Nyeun Kim, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001284:Atrophy; D004359:Drug Therapy, Combination; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D016609:Neoplasms, Second Primary; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Endoscopic submucosal dissection; Helicobacter pylori; Metachronous gastric cancer