Abstract：
This study aimed to update the association between Helicobacter pylori (H. pylori) infection and gastric cancer (GC).
We searched PubMed, Embase, and Cochrane Library from 1990 to December 2021 to identify prospective studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were summarized to validate the relationship between H. pylori infection and GC.
Including 27 studies, findings indicated a strong link between H. pylori and non-cardia gastric cancer (NCGC) in both Europe/North America (OR=5.37, 95%CI:4.39-6.57) and Asia (OR = 2.50, 95%CI:1.89-3.32), and a positive association with cardia gastric cancer (CGC) in Asia (OR = 1.74, 95%CI:1.38-2.19), but an inverse association in European/American populations (OR = 0.64, 95%CI: 0.51 to 0.79). Furthermore, the strength of association was greater in studies that detected H. pylori by immunoblotting versus ELISA, and also in studies testing for H. pylori detection further back in time prior to cancer diagnosis (Ptrend<0.05). Approximately 79% of NCGC in Asia and 87% in Europe/North America, along with 62% of CGC in Asia, could be attributable to H. pylori infection.
The meta-analysis supports the significant attributable risk of H. pylori infection for GC and underscores the potential impact of targeting H. pylori in GC prevention programs.
CRD42021274120.
We searched PubMed, Embase, and Cochrane Library from 1990 to December 2021 to identify prospective studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were summarized to validate the relationship between H. pylori infection and GC.
Including 27 studies, findings indicated a strong link between H. pylori and non-cardia gastric cancer (NCGC) in both Europe/North America (OR=5.37, 95%CI:4.39-6.57) and Asia (OR = 2.50, 95%CI:1.89-3.32), and a positive association with cardia gastric cancer (CGC) in Asia (OR = 1.74, 95%CI:1.38-2.19), but an inverse association in European/American populations (OR = 0.64, 95%CI: 0.51 to 0.79). Furthermore, the strength of association was greater in studies that detected H. pylori by immunoblotting versus ELISA, and also in studies testing for H. pylori detection further back in time prior to cancer diagnosis (Ptrend<0.05). Approximately 79% of NCGC in Asia and 87% in Europe/North America, along with 62% of CGC in Asia, could be attributable to H. pylori infection.
The meta-analysis supports the significant attributable risk of H. pylori infection for GC and underscores the potential impact of targeting H. pylori in GC prevention programs.
CRD42021274120.
摘要：
■本研究旨在提供汇总，对幽门螺杆菌(H.幽门螺杆菌）感染和胃癌（GC）的发展。
■我们搜索了PubMed，Embase,和Cochrane图书馆从1990年到2021年12月，以确定前瞻性研究，即嵌套病例对照或病例队列研究。汇总比值比（ORs）和95％置信区间（CIs），以验证幽门螺杆菌感染与GC之间的关系。评估异质性和发表偏倚，并按亚组进行随机效应荟萃分析。
■共纳入27项研究。在欧洲/北美（OR=5.37，95CI：4.39-6.57）和亚洲（OR=2.50，95CI：1.89-3.32），幽门螺杆菌感染与非贲门胃癌（NCGC）密切相关。在亚洲，幽门螺杆菌感染也与贲门胃癌（CGC）呈正相关（OR=1.74，95CI：1.38-2.19），但不是在欧洲/美国人口中，其中关联是相反的(OR=0.64，95CI：0.51至0.79)。此外，与ELISA相比，通过免疫印迹检测幽门螺杆菌的研究中的关联强度更大，对于NCGC和亚洲的CGC，以及在癌症诊断前进一步检测幽门螺杆菌检测的研究(Ptrend<0.05)。亚洲约79%的NCGC，87%的NCGC在欧洲/北美，亚洲62%的CGC可归因于幽门螺杆菌感染。
■这项荟萃分析总结了幽门螺杆菌感染与GC之间关联的前瞻性证据，为幽门螺杆菌靶向GC预防计划的可归因风险和潜在影响提供可靠的估计。
■CRD42021274120。
■我们搜索了PubMed，Embase,和Cochrane图书馆从1990年到2021年12月，以确定前瞻性研究，即嵌套病例对照或病例队列研究。汇总比值比（ORs）和95％置信区间（CIs），以验证幽门螺杆菌感染与GC之间的关系。评估异质性和发表偏倚，并按亚组进行随机效应荟萃分析。
■共纳入27项研究。在欧洲/北美（OR=5.37，95CI：4.39-6.57）和亚洲（OR=2.50，95CI：1.89-3.32），幽门螺杆菌感染与非贲门胃癌（NCGC）密切相关。在亚洲，幽门螺杆菌感染也与贲门胃癌（CGC）呈正相关（OR=1.74，95CI：1.38-2.19），但不是在欧洲/美国人口中，其中关联是相反的(OR=0.64，95CI：0.51至0.79)。此外，与ELISA相比，通过免疫印迹检测幽门螺杆菌的研究中的关联强度更大，对于NCGC和亚洲的CGC，以及在癌症诊断前进一步检测幽门螺杆菌检测的研究(Ptrend<0.05)。亚洲约79%的NCGC，87%的NCGC在欧洲/北美，亚洲62%的CGC可归因于幽门螺杆菌感染。
■这项荟萃分析总结了幽门螺杆菌感染与GC之间关联的前瞻性证据，为幽门螺杆菌靶向GC预防计划的可归因风险和潜在影响提供可靠的估计。
■CRD42021274120。
