Hack-Lyoung Kim, Dong-Hoon Kim, Kyueng-Whan Min, Byoung Kwan Son, Jaehoon Chung
Helicobacter pylori (HP) infection has been linked to systemic inflammation and vascular dysfunction, potentially contributing to arterial stiffness. Research in younger populations is limited, highlighting the need to explore its early cardiovascular impact. This study investigated the association between histologically confirmed HP infection and arterial stiffness. Data were retrospectively analyzed from a cohort of adults who underwent health check-ups and gastric mucosal biopsies to confirm HP infection. A mong them, young adults aged 19–39 years were included in the analysis. Arterial stiffness was assessed using estimated PWV (ePWV), which was calculated using age and mean arterial pressure according to validated equations. Among 7803 participants, 4289 (53.9%) tested positive for HP. ePWV was significantly higher in HP-positive individuals (6.66 ± 0.60 vs. 6.33 ± 0.58 m/s; p < 0.001), with a linear increase observed across HP severity levels (analysis of variaungnce p < 0.01). A positive correlation was identified between the Updated Sydney System (USS) score and ePWV (p < 0.001). Multiple linear regression analysis demonstrated an independent association between USS score and ePWV after adjusting for confounders. Logistic regression analysis showed that severe HP infection was associated with a markedly higher likelihood of elevated ePWV (odds ratio, 3.87; 95% CI. 3.25–4.60; p < 0.001). HP infection was independently associated with increased arterial stiffness in young adualts, with greater infection severity linked to higher ePWV levels. Early detection may help reduce long-term cardiovascular risk.
幽门螺杆菌（HP）感染与全身炎症和血管功能障碍有关，可能导致动脉僵硬。对年轻人群的研究是有限的，这突出了探索其早期心血管影响的必要性。本研究调查了组织学证实的HP感染与动脉僵硬之间的关系。回顾性分析了一组接受健康检查和胃粘膜活检以确认HP感染的成年人的数据。其中19-39岁的年轻人被纳入分析。通过估算的PWV （ePWV）来评估动脉刚度，ePWV是根据年龄和平均动脉压根据验证方程计算的。在7803名参与者中，4289人（53.9%）检测出HP阳性。HP阳性个体的ePWV显著升高（6.66±0.60 vs. 6.33±0.58 m/s; p < 0.001），且在不同HP严重程度之间呈线性增加（方差分析p <； 0.01）。更新悉尼系统（USS）评分与ePWV呈正相关（p < 0.001）。多元线性回归分析表明，在调整混杂因素后，USS评分与ePWV之间存在独立的关联。Logistic回归分析显示，严重HP感染与ePWV升高的可能性显著增高相关（优势比3.87;95% CI）。3.25 - -4.60;P < 0.001)。HP感染与年轻人动脉僵硬度增加独立相关，感染严重程度越高，ePWV水平越高。早期发现可能有助于降低长期心血管风险。
{"title":"Arterial Stiffness and Histologically Confirmed Helicobacter pylori Infection in Young Adults","authors":"Hack-Lyoung Kim, Dong-Hoon Kim, Kyueng-Whan Min, Byoung Kwan Son, Jaehoon Chung","doi":"10.1111/hel.70067","DOIUrl":"https://doi.org/10.1111/hel.70067","url":null,"abstract":"<div>\u0000 \u0000 <p><i>Helicobacter pylori</i> (HP) infection has been linked to systemic inflammation and vascular dysfunction, potentially contributing to arterial stiffness. Research in younger populations is limited, highlighting the need to explore its early cardiovascular impact. This study investigated the association between histologically confirmed HP infection and arterial stiffness. Data were retrospectively analyzed from a cohort of adults who underwent health check-ups and gastric mucosal biopsies to confirm HP infection. A mong them, young adults aged 19–39 years were included in the analysis. Arterial stiffness was assessed using estimated PWV (ePWV), which was calculated using age and mean arterial pressure according to validated equations. Among 7803 participants, 4289 (53.9%) tested positive for HP. ePWV was significantly higher in HP-positive individuals (6.66 ± 0.60 vs. 6.33 ± 0.58 m/s; <i>p</i> < 0.001), with a linear increase observed across HP severity levels (analysis of variaungnce <i>p</i> < 0.01). A positive correlation was identified between the Updated Sydney System (USS) score and ePWV (<i>p</i> < 0.001). Multiple linear regression analysis demonstrated an independent association between USS score and ePWV after adjusting for confounders. Logistic regression analysis showed that severe HP infection was associated with a markedly higher likelihood of elevated ePWV (odds ratio, 3.87; 95% CI. 3.25–4.60; <i>p</i> < 0.001). HP infection was independently associated with increased arterial stiffness in young adualts, with greater infection severity linked to higher ePWV levels. Early detection may help reduce long-term cardiovascular risk.</p>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luochengling Xiang, Ying Zhou, Xiaopei Guo, Michiel C. Mommersteeg, Stella A. V. Nieuwenburg, Maikel P. Peppelenbosch, Manon C. W. Spaander, Gwenny M. Fuhler
Background
A lateral flow assay (LFA) incorporating several biomarkers, including pepsinogen I (PGI), pepsinogen II (PGII), Gastrin-17 (G-17), and Helicobacter pylori IgG, enables the rapid non-invasive detection of atrophic gastritis (AG). However, its diagnostic performance compared to conventional enzyme-linked immunosorbent assay (ELISA) has not been established.
Methods
This head-to-head comparison study included participants from a prospective and multicenter cohort. Patients with gastric premalignant lesions underwent endoscopy, and fasting serum samples were collected for biomarker analysis using both LFA and ELISA.
Results
A total of 204 patients were included in this study. LFA demonstrated diagnostic specificity for AG comparable to ELISA, with specificity rates of 95.74% (95% CI [85.75%–99.24%]) for LFA and 100.00% (95% CI [92.44%–100.00%]) for ELISA (p = 0.49). Both methods showed similar performance in detecting H. pylori infection, with an AUC of 0.754 (95% CI [0.616–0.891]) for LFA and 0.778 (95% CI [0.633–0.922]) for ELISA (p = 0.70). For identifying autoimmune gastritis in corpus AG, a reduced PGI/PGII ratio combined with elevated G-17 levels provided excellent discrimination, achieving an AUC of 0.926 (95% CI [0.870–0.926]) for LFA and 0.924 (95% CI [0.861–0.924]) for ELISA.
Conclusion
The LFA assay is a feasible, rapid, and non-invasive tool for assessing gastric functional mucosa. Its diagnostic performance for detecting AG is comparable to ELISA, making it a supplementary tool in point-of-care settings to improve the early detection of AG.
Trial Registration
This study was not registered as a clinical trial, as it is based on an observational study, Progression and Regression of precancerous Gastric Lesions (PROREGAL) study.
横向流动试验（LFA）包含了多种生物标志物，包括胃蛋白酶原I （PGI）、胃蛋白酶原II （PGII）、胃泌素-17 （G-17）和幽门螺杆菌IgG，能够快速无创检测萎缩性胃炎（AG）。然而，与传统的酶联免疫吸附试验（ELISA）相比，其诊断性能尚未确定。方法本研究纳入了前瞻性多中心队列。胃癌前病变患者行胃镜检查，并收集空腹血清样本，采用LFA和ELISA进行生物标志物分析。结果本研究共纳入204例患者。LFA对AG的诊断特异性与ELISA相当，LFA的特异性为95.74% (95% CI [85.75% ~ 99.24%])， ELISA的特异性为100.00% (95% CI [92.44% ~ 100.00%]) （p = 0.49）。两种方法检测幽门螺杆菌感染的效果相似，LFA的AUC为0.754 (95% CI [0.616-0.891])， ELISA的AUC为0.778 (95% CI [0.633-0.922]) （p = 0.70）。对于鉴别自身免疫性胃炎，PGI/PGII比值降低结合G-17水平升高提供了很好的鉴别，LFA的AUC为0.926 (95% CI [0.870-0.926])， ELISA的AUC为0.924 （95% CI[0.861-0.924]）。结论LFA法是一种可行、快速、无创的胃粘膜功能评价方法。其检测AG的诊断性能与ELISA相当，使其成为护理点环境中提高AG早期检测的补充工具。这项研究没有注册为临床试验，因为它是基于一项观察性研究，癌前胃病变的进展和消退（PROREGAL）研究。
{"title":"Evaluation of Pepsinogen I, II, Gastrin 17 and Helicobacter pylori IgG in Atrophic Gastritis: A Head-To-Head Comparison of Lateral Flow and Enzyme-Linked Immunosorbent Assays","authors":"Luochengling Xiang, Ying Zhou, Xiaopei Guo, Michiel C. Mommersteeg, Stella A. V. Nieuwenburg, Maikel P. Peppelenbosch, Manon C. W. Spaander, Gwenny M. Fuhler","doi":"10.1111/hel.70066","DOIUrl":"https://doi.org/10.1111/hel.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A lateral flow assay (LFA) incorporating several biomarkers, including pepsinogen I (PGI), pepsinogen II (PGII), Gastrin-17 (G-17), and <i>Helicobacter pylori</i> IgG, enables the rapid non-invasive detection of atrophic gastritis (AG). However, its diagnostic performance compared to conventional enzyme-linked immunosorbent assay (ELISA) has not been established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This head-to-head comparison study included participants from a prospective and multicenter cohort. Patients with gastric premalignant lesions underwent endoscopy, and fasting serum samples were collected for biomarker analysis using both LFA and ELISA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 204 patients were included in this study. LFA demonstrated diagnostic specificity for AG comparable to ELISA, with specificity rates of 95.74% (95% CI [85.75%–99.24%]) for LFA and 100.00% (95% CI [92.44%–100.00%]) for ELISA (<i>p</i> = 0.49). Both methods showed similar performance in detecting <i>H. pylori</i> infection, with an AUC of 0.754 (95% CI [0.616–0.891]) for LFA and 0.778 (95% CI [0.633–0.922]) for ELISA (<i>p</i> = 0.70). For identifying autoimmune gastritis in corpus AG, a reduced PGI/PGII ratio combined with elevated G-17 levels provided excellent discrimination, achieving an AUC of 0.926 (95% CI [0.870–0.926]) for LFA and 0.924 (95% CI [0.861–0.924]) for ELISA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LFA assay is a feasible, rapid, and non-invasive tool for assessing gastric functional mucosa. Its diagnostic performance for detecting AG is comparable to ELISA, making it a supplementary tool in point-of-care settings to improve the early detection of AG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This study was not registered as a clinical trial, as it is based on an observational study, Progression and Regression of precancerous Gastric Lesions (PROREGAL) study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Autoimmune gastritis (AIG) is a chronic immune-mediated disease characterized by the presence of anti-parietal cell antibody and progressive corpus-predominant atrophy. The global prevalence of AIG and its associated factors remain poorly understood. This study aimed to systematically estimate the prevalence of AIG worldwide and identify demographic and diagnostic factors influencing its variability.
Methods
In this systematic review and meta-analysis, we searched Medline, Scopus, and Embase from database inception until December 7, 2024. Prevalence was pooled using a random-effects model, and potential sources of heterogeneity were explored by subgroup analysis and meta-regression analysis.
Results
A total of 47 studies involving 15,817 individuals were included. The global prevalence of AIG was estimated at 3.85% (95% CI: 2.94–5.04, I2 = 99.3%). Notable geographical variation was observed, with a prevalence of 4.94% in Europe (95% CI: 3.66–6.63), 2.23% in Asia (95% CI: 1.19–4.14), 2.82% in America (95% CI: 1.48–5.31), 8.46% in Africa (95% CI: 5.58–13.14) and 8.08% in Australia (95% CI: 4.69–12.79). The prevalence was highest when diagnosed by serological antibody (5.4%, 95% CI: 3.79–7.65), followed by histology (2.71%, 95% CI: 1.68–4.36) and combined serology and histology (1.81%, 95% CI: 0.80–4.07). Meta-regression analysis revealed a positive correlation between H. pylori infection and AIG prevalence.
Conclusions
This study estimated the global prevalence of AIG and underscored the significant geographical and methodological variability. Future studies of large-scale are still in urgent need to standardize the diagnostic criteria and further investigate risk factors, thus enhancing the understanding and management of AIG.
{"title":"Prevalence of Autoimmune Gastritis Worldwide: A Systematic Review and Meta-Analysis","authors":"Meixuan Li, Yu Huang, Xiao Liang, Hong Lu","doi":"10.1111/hel.70065","DOIUrl":"https://doi.org/10.1111/hel.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autoimmune gastritis (AIG) is a chronic immune-mediated disease characterized by the presence of anti-parietal cell antibody and progressive corpus-predominant atrophy. The global prevalence of AIG and its associated factors remain poorly understood. This study aimed to systematically estimate the prevalence of AIG worldwide and identify demographic and diagnostic factors influencing its variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this systematic review and meta-analysis, we searched Medline, Scopus, and Embase from database inception until December 7, 2024. Prevalence was pooled using a random-effects model, and potential sources of heterogeneity were explored by subgroup analysis and meta-regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 47 studies involving 15,817 individuals were included. The global prevalence of AIG was estimated at 3.85% (95% CI: 2.94–5.04, <i>I</i><sup><i>2</i></sup> = 99.3%). Notable geographical variation was observed, with a prevalence of 4.94% in Europe (95% CI: 3.66–6.63), 2.23% in Asia (95% CI: 1.19–4.14), 2.82% in America (95% CI: 1.48–5.31), 8.46% in Africa (95% CI: 5.58–13.14) and 8.08% in Australia (95% CI: 4.69–12.79). The prevalence was highest when diagnosed by serological antibody (5.4%, 95% CI: 3.79–7.65), followed by histology (2.71%, 95% CI: 1.68–4.36) and combined serology and histology (1.81%, 95% CI: 0.80–4.07). Meta-regression analysis revealed a positive correlation between <i>H. pylori</i> infection and AIG prevalence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study estimated the global prevalence of AIG and underscored the significant geographical and methodological variability. Future studies of large-scale are still in urgent need to standardize the diagnostic criteria and further investigate risk factors, thus enhancing the understanding and management of AIG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 10 day vonoprazan–amoxicillin (VA) regimen (amoxicillin 750 mg four times daily) achieved > 90% Helicobacter pylori (H. pylori) eradication rates in the initial treatment. Whether less frequent dosing or shorter duration provides comparable efficacy remains unclear. This study aimed to evaluate the efficacy of simplified 7 or 10-day VA regimens to determine the optimal first-line strategy.
Methods
In this multicenter, randomized, open-label, non-inferiority trial, treatment-naive H. pylori-positive patients were randomly assigned (1:1:1:1) to four treatment groups: VA-T7 (amoxicillin 1000 mg three times daily for 7 days), VA-Q7 (amoxicillin 750 mg four times daily for 7 days), VA-T10 (amoxicillin 1000 mg three times daily for 10 days), and VA-Q10 (amoxicillin 750 mg four times daily for 10 days). All the patients received vonoprazan 20 mg twice daily. The primary outcome was the eradication rate. The secondary outcomes included adverse events and adherence.
Results
A total of 500 patients were enrolled. The eradication rates of the VA-T7, VA-Q7, VA-T10, and VA-Q10 groups were 84.0%, 81.6%, 91.2%, and 90.4% by intention-to-treat (ITT) analysis; 86.8%, 83.6%, 92.7%, and 92.6% by modified intention-to-treat (mITT) analysis; 88.2%, 85.7%, 93.4%, and 94.1% by per-protocol (PP) analysis, respectively. The efficacy of VA-T10 was non-inferior to that of VA-Q10 (p = 0.002; p = 0.001; p = 0.002 in the ITT, mITT and PP analyses, respectively). Both 7-day regimens failed to meet the non-inferiority margin of −10%. No significant effect of dosing frequency on eradication rates was observed. Adverse events and adherence were comparable among the groups.
Conclusions
The VA-T10 regimen is effective, well-tolerated, and suitable for first-line H. pylori eradication, whereas 7-day regimens are not recommended due to eradication rates < 90%.
{"title":"Optimizing Duration and Dosing Frequency of Vonoprazan–Amoxicillin Dual Therapy for Helicobacter pylori: A Multicenter Randomized Trial","authors":"Lulong Tao, Haisheng Qian, Leyao Zhang, Peipei Luo, Shijie Ma, Jin Yan, Yajun Liu, Meihong Chen, Yuwen Tao, Jinjin Shi, Guoxin Zhang, Feng Ye","doi":"10.1111/hel.70062","DOIUrl":"https://doi.org/10.1111/hel.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A 10 day vonoprazan–amoxicillin (VA) regimen (amoxicillin 750 mg four times daily) achieved > 90% <i>Helicobacter pylori (H. pylori)</i> eradication rates in the initial treatment. Whether less frequent dosing or shorter duration provides comparable efficacy remains unclear. This study aimed to evaluate the efficacy of simplified 7 or 10-day VA regimens to determine the optimal first-line strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter, randomized, open-label, non-inferiority trial, treatment-naive <i>H. pylori</i>-positive patients were randomly assigned (1:1:1:1) to four treatment groups: VA-T7 (amoxicillin 1000 mg three times daily for 7 days), VA-Q7 (amoxicillin 750 mg four times daily for 7 days), VA-T10 (amoxicillin 1000 mg three times daily for 10 days), and VA-Q10 (amoxicillin 750 mg four times daily for 10 days). All the patients received vonoprazan 20 mg twice daily. The primary outcome was the eradication rate. The secondary outcomes included adverse events and adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 500 patients were enrolled. The eradication rates of the VA-T7, VA-Q7, VA-T10, and VA-Q10 groups were 84.0%, 81.6%, 91.2%, and 90.4% by intention-to-treat (ITT) analysis; 86.8%, 83.6%, 92.7%, and 92.6% by modified intention-to-treat (mITT) analysis; 88.2%, 85.7%, 93.4%, and 94.1% by per-protocol (PP) analysis, respectively. The efficacy of VA-T10 was non-inferior to that of VA-Q10 (<i>p</i> = 0.002; <i>p</i> = 0.001; <i>p</i> = 0.002 in the ITT, mITT and PP analyses, respectively). Both 7-day regimens failed to meet the non-inferiority margin of −10%. No significant effect of dosing frequency on eradication rates was observed. Adverse events and adherence were comparable among the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The VA-T10 regimen is effective, well-tolerated, and suitable for first-line <i>H. pylori</i> eradication, whereas 7-day regimens are not recommended due to eradication rates < 90%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: ChiCTR2400079754 (www.chictr.org.cn)</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matjaž Homan, Zrinjka Mišak, Francis Megraud, Michal Kori
Helicobacter pylori infection in children and adults differs in several aspects such as the natural history, prevalence, the clinical presentations and complications, antibiotic resistance rates, treatment options, and the success rates of treatment. Due to all the abovementioned differences, management guidelines and recommendations are different between children and adults. In parallel to the steady decrease in the rate of H. pylori infection in the Western world in recent years, both in children and adults, antibiotic resistance rates have risen to alarming rates. The risk and benefits of eradication treatment, especially in children, must be considered when deciding “to treat or not.” The risks include the negative effects of antibiotics, treatment failure, and reinfection as well as the possibility of losing the “protective effect” of H. pylori on atopy, allergy, and possibly on other gastrointestinal diseases. On the other hand, there are also many benefits of eradication therapy such as prevention of gastric complication and associated non-gastric complications as well as reduction of parental anxiety of nontreatment. This review summarizes the differences related to H. pylori in children versus adults and the risks and benefits of treatment in children.
{"title":"Helicobacter pylori Infection in Children Versus Adults, Differences in Management Guidelines: Risks and Benefits of Treatment in Childhood","authors":"Matjaž Homan, Zrinjka Mišak, Francis Megraud, Michal Kori","doi":"10.1111/hel.70063","DOIUrl":"https://doi.org/10.1111/hel.70063","url":null,"abstract":"<p><i>Helicobacter pylori</i> infection in children and adults differs in several aspects such as the natural history, prevalence, the clinical presentations and complications, antibiotic resistance rates, treatment options, and the success rates of treatment. Due to all the abovementioned differences, management guidelines and recommendations are different between children and adults. In parallel to the steady decrease in the rate of <i>H. pylori</i> infection in the Western world in recent years, both in children and adults, antibiotic resistance rates have risen to alarming rates. The risk and benefits of eradication treatment, especially in children, must be considered when deciding “to treat or not.” The risks include the negative effects of antibiotics, treatment failure, and reinfection as well as the possibility of losing the “protective effect” of <i>H. pylori</i> on atopy, allergy, and possibly on other gastrointestinal diseases. On the other hand, there are also many benefits of eradication therapy such as prevention of gastric complication and associated non-gastric complications as well as reduction of parental anxiety of nontreatment. This review summarizes the differences related to <i>H. pylori</i> in children versus adults and the risks and benefits of treatment in children.</p>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helicobacter pylori (H. pylori) is a pathobiont that infects around two-thirds of the global population and has demonstrated a rise in antibiotic resistance, warranting a search for alternative treatments. As fatty acid biosynthesis is central to membrane structure and function, and H. pylori is correlated with the erosion of the mucosal barrier, lipidome analysis can elucidate the role of fatty acid metabolism in H. pylori infection and yield potential targets for intervention.
Materials and Methods
Fecal samples from 68 H. pylori patients and 35 healthy control subjects were analyzed for fatty acid composition using gas chromatography–mass spectrometry.
Results
We observed an increase in margaric acid/17:0, eicosapentaenoic acid (EPA)/20:5n3, erucic acid/22:1n9, and docosapentaenoic acid (DPA)/22:5n3 as well as eicosatetraenoic acid/20:4n3 and docosahexaenoic acid (DHA)/22:6n3 in H. pylori patients relative to the healthy control subjects. In contrast, the PUFAs gamma-linolenic acid/18:3n6 and osbond acid/22:5n6 were decreased in the H. pylori patients relative to healthy controls. Most of the fatty acids that differ in quantity between H. pylori-positive samples and controls are metabolites of omega-3 and omega-6 fatty acid metabolism. Smoking, alcohol use, and non-ulcer dyspepsia further influenced fatty acid metabolism during H. pylori infection.
Conclusions
Here, we propose a model for the pathophysiology of H. pylori infection based on the gut lipid signatures of H. pylori patients and healthy control subjects. Our results may provide insight on how H. pylori infection leads to changes in fatty acid metabolism, how the host responds, and which metabolites may serve as potential candidates for future interventions.
{"title":"Lipidome Characterization Reveals Alterations of Fatty Acid Metabolism in Helicobacter pylori Infection","authors":"Hyder Alikhan, Jaclyn Levendusky, Nicole Leonick, Marina Farag, Charalampos Papachristou, Babis, Lark Perez, Joshua DeSipio, Sangita Phadtare","doi":"10.1111/hel.70060","DOIUrl":"https://doi.org/10.1111/hel.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) is a pathobiont that infects around two-thirds of the global population and has demonstrated a rise in antibiotic resistance, warranting a search for alternative treatments. As fatty acid biosynthesis is central to membrane structure and function, and <i>H. pylori</i> is correlated with the erosion of the mucosal barrier, lipidome analysis can elucidate the role of fatty acid metabolism in <i>H. pylori</i> infection and yield potential targets for intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Fecal samples from 68 <i>H. pylori</i> patients and 35 healthy control subjects were analyzed for fatty acid composition using gas chromatography–mass spectrometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed an increase in margaric acid/17:0, eicosapentaenoic acid (EPA)/20:5n3, erucic acid/22:1n9, and docosapentaenoic acid (DPA)/22:5n3 as well as eicosatetraenoic acid/20:4n3 and docosahexaenoic acid (DHA)/22:6n3 in <i>H. pylori</i> patients relative to the healthy control subjects. In contrast, the PUFAs gamma-linolenic acid/18:3n6 and osbond acid/22:5n6 were decreased in the <i>H. pylori</i> patients relative to healthy controls. Most of the fatty acids that differ in quantity between <i>H. pylori</i>-positive samples and controls are metabolites of omega-3 and omega-6 fatty acid metabolism. Smoking, alcohol use, and non-ulcer dyspepsia further influenced fatty acid metabolism during <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Here, we propose a model for the pathophysiology of <i>H. pylori</i> infection based on the gut lipid signatures of <i>H. pylori</i> patients and healthy control subjects. Our results may provide insight on how <i>H. pylori</i> infection leads to changes in fatty acid metabolism, how the host responds, and which metabolites may serve as potential candidates for future interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. B. Mourato, N. Pratas, A. Branco Pereira, F. Costa Pinto, R. Dinis, I. Fronteira, M. Areia
Background
Gastric cancer remains a major global health concern and is still frequently diagnosed at advanced stages in Western countries. Despite increasing evidence supporting the role of endoscopic screening in intermediate-risk regions such as Portugal, no national program currently exists. This study aimed to evaluate the feasibility, adherence, and diagnostic yield of opportunistic upper endoscopy performed simultaneously with colorectal cancer screening.
Material and Methods
We conducted an observational retrospective study including individuals aged 50–74 years scheduled for a screening colonoscopy, who were invited to undergo an additional upper gastrointestinal endoscopy, between February 2023 and February 2025 in two endoscopy units in the Alentejo region of Portugal. Data regarding demographics, endoscopic findings, and histology were collected and analyzed descriptively.
Results
Of 401 individuals invited, 380 (94.8%) accepted and underwent upper endoscopy, and 377 were included in the final analysis. Histological findings included Helicobacter pylori infection (30.8%), chronic atrophic gastritis (36.9%) and intestinal metaplasia (10.1%). Regarding neoplastic lesions, 2 cases (0.5%) of low-grade intraepithelial neoplasia, 3 cases (0.8%) of gastric adenocarcinoma, and 2 cases (0.5%) of gastrointestinal stromal tumors were identified, yielding a total malignancy rate of 1.9%; no early gastric cancers were identified. Colorectal findings included 29.2% precancerous lesions and 3.4% invasive colorectal cancer.
Conclusion
This study confirms that opportunistic upper endoscopic screening, integrated into colorectal cancer-screening programs, is feasible, well accepted, and diagnostically valuable in an intermediate-risk Western population. The high rate of precancerous conditions and malignant lesions detected reinforces the need for structured screening strategies. These results align with international recommendations and provide real-world evidence to support broader implementation in similar healthcare contexts.
{"title":"Gastric Cancer Endoscopic Screening in an Intermediate-Risk Country—A Dual-Center Pilot Program","authors":"M. B. Mourato, N. Pratas, A. Branco Pereira, F. Costa Pinto, R. Dinis, I. Fronteira, M. Areia","doi":"10.1111/hel.70061","DOIUrl":"https://doi.org/10.1111/hel.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric cancer remains a major global health concern and is still frequently diagnosed at advanced stages in Western countries. Despite increasing evidence supporting the role of endoscopic screening in intermediate-risk regions such as Portugal, no national program currently exists. This study aimed to evaluate the feasibility, adherence, and diagnostic yield of opportunistic upper endoscopy performed simultaneously with colorectal cancer screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We conducted an observational retrospective study including individuals aged 50–74 years scheduled for a screening colonoscopy, who were invited to undergo an additional upper gastrointestinal endoscopy, between February 2023 and February 2025 in two endoscopy units in the Alentejo region of Portugal. Data regarding demographics, endoscopic findings, and histology were collected and analyzed descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 401 individuals invited, 380 (94.8%) accepted and underwent upper endoscopy, and 377 were included in the final analysis. Histological findings included <i>Helicobacter pylori</i> infection (30.8%), chronic atrophic gastritis (36.9%) and intestinal metaplasia (10.1%). Regarding neoplastic lesions, 2 cases (0.5%) of low-grade intraepithelial neoplasia, 3 cases (0.8%) of gastric adenocarcinoma, and 2 cases (0.5%) of gastrointestinal stromal tumors were identified, yielding a total malignancy rate of 1.9%; no early gastric cancers were identified. Colorectal findings included 29.2% precancerous lesions and 3.4% invasive colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study confirms that opportunistic upper endoscopic screening, integrated into colorectal cancer-screening programs, is feasible, well accepted, and diagnostically valuable in an intermediate-risk Western population. The high rate of precancerous conditions and malignant lesions detected reinforces the need for structured screening strategies. These results align with international recommendations and provide real-world evidence to support broader implementation in similar healthcare contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT06316882</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rizki Amalia, Muhammad Miftahussurur, Yoshio Yamaoka
{"title":"Response to the Letter by Guo Et al. Regarding “Parietal Cell Antibody Levels Among Chronic Gastritis Patients in a Country With Low Helicobacter pylori Infection”","authors":"Rizki Amalia, Muhammad Miftahussurur, Yoshio Yamaoka","doi":"10.1111/hel.70055","DOIUrl":"https://doi.org/10.1111/hel.70055","url":null,"abstract":"","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tian-Lian Yan, Jing-Hua Wang, Ren-Ke Zhu, Hao-Liang Zhai, Zhen-Zhen Wang, Xin-Li Mao, Xian Shen, Ping Xu, Dan Ma, Xin-Jue He, Jie-Wei Wang, Jian-Guo Gao, Ling-Ling Jiang, Kefang Sun, Ye Chen, Jian-Zhong Sang, Xiao-Qin Liu, Jiao-E Chen, Lan Li
<div> <section> <h3> Background</h3> <p>Rescue treatment for non-naive patients with persistent <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is lacking, especially in areas where tetracycline is unavailable. This trial aimed to evaluate the efficacy and safety of replacing proton pump inhibitor (PPI) with potassium-competitive acid blocker (P-CAB) in bismuth quadruple therapy (BQT) containing amoxicillin and furazolidone as rescue therapy.</p> </section> <section> <h3> Materials and Methods</h3> <p>We conducted a prospective, open-label, noninferiority randomized controlled trial at six institutions in eastern China. A total of 444 patients with a history of <i>H. pylori</i> treatment failure were enrolled and randomly assigned in a 1:1 ratio to either the 14-day P-CAB-BQT group (vonoprazan 20 mg, colloidal bismuth 200 mg, amoxicillin 1000 mg and furazolidone 100 mg, all given twice daily) or the 14-day PPI-BQT group (rabeprazole 10 mg given twice daily, and the same dose of three other drugs as the 14-day P-CAB-BQT group). The primary endpoint was the eradication rate assessed by <sup>13</sup>C urea breath test. The secondary endpoints were adverse events and compliance.</p> </section> <section> <h3> Results</h3> <p><i>H. pylori</i> eradication rates of PPI-BQT versus P-CAB-BQT group were 83.8% versus 91.9% in the intention-to-treat (ITT) analysis (treatment difference: 8.1%; 95% CI: 2.1%–14.1%; non-inferiority <i>p</i> < 0.001, <i>p</i>-value for difference = 0.008); 86.1% versus 95.8% in the modified ITT (MITT) analysis (treatment difference: 9.7%; 95% CI: 4.4%–15.0%; non-inferiority <i>p</i> < 0.001, <i>p</i>-value for difference < 0.001); and 86.3% versus 95.6% in the per-protocol (PP) analysis (treatment difference: 9.3%; 95% CI: 3.8%–14.8%; non-inferiority <i>p</i> < 0.001, <i>p</i>-value for difference < 0.001). The P-CAB-BQT regimen was shown to be non-inferior to the PPI-BQT regimen and yielded higher eradication rates across all analysis populations (ITT, MITT, and PP). The overall frequency of adverse events (27.9% and 34.2%, <i>p</i> = 0.151) and compliance (93.7% and 94.6%, <i>p</i> = 0.686) were similar between PPI and P-CAB groups. Among the patients suspected of drug-induced fever (8.6% and 7.2%, <i>p</i> = 0.597), 82.9% experienced fever after administration of furazolidone for > 10 days. The eradication rates were not affected by prior choice of antibiotics and the number of treatment attempts.</p> </section> <section> <h3> Conclusions</h3> <p>The 14-day P-CAB-BQT therapy containing amoxicillin and furazolidone provided a satisfactory eradication rate and a good safety profile as res
{"title":"Vonoprazan Improves Efficacy of Bismuth Quadruple Therapy for Helicobacter pylori Rescue Treatment: A Multicenter Randomized Controlled Trial","authors":"Tian-Lian Yan, Jing-Hua Wang, Ren-Ke Zhu, Hao-Liang Zhai, Zhen-Zhen Wang, Xin-Li Mao, Xian Shen, Ping Xu, Dan Ma, Xin-Jue He, Jie-Wei Wang, Jian-Guo Gao, Ling-Ling Jiang, Kefang Sun, Ye Chen, Jian-Zhong Sang, Xiao-Qin Liu, Jiao-E Chen, Lan Li","doi":"10.1111/hel.70056","DOIUrl":"https://doi.org/10.1111/hel.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rescue treatment for non-naive patients with persistent <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection is lacking, especially in areas where tetracycline is unavailable. This trial aimed to evaluate the efficacy and safety of replacing proton pump inhibitor (PPI) with potassium-competitive acid blocker (P-CAB) in bismuth quadruple therapy (BQT) containing amoxicillin and furazolidone as rescue therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a prospective, open-label, noninferiority randomized controlled trial at six institutions in eastern China. A total of 444 patients with a history of <i>H. pylori</i> treatment failure were enrolled and randomly assigned in a 1:1 ratio to either the 14-day P-CAB-BQT group (vonoprazan 20 mg, colloidal bismuth 200 mg, amoxicillin 1000 mg and furazolidone 100 mg, all given twice daily) or the 14-day PPI-BQT group (rabeprazole 10 mg given twice daily, and the same dose of three other drugs as the 14-day P-CAB-BQT group). The primary endpoint was the eradication rate assessed by <sup>13</sup>C urea breath test. The secondary endpoints were adverse events and compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>H. pylori</i> eradication rates of PPI-BQT versus P-CAB-BQT group were 83.8% versus 91.9% in the intention-to-treat (ITT) analysis (treatment difference: 8.1%; 95% CI: 2.1%–14.1%; non-inferiority <i>p</i> < 0.001, <i>p</i>-value for difference = 0.008); 86.1% versus 95.8% in the modified ITT (MITT) analysis (treatment difference: 9.7%; 95% CI: 4.4%–15.0%; non-inferiority <i>p</i> < 0.001, <i>p</i>-value for difference < 0.001); and 86.3% versus 95.6% in the per-protocol (PP) analysis (treatment difference: 9.3%; 95% CI: 3.8%–14.8%; non-inferiority <i>p</i> < 0.001, <i>p</i>-value for difference < 0.001). The P-CAB-BQT regimen was shown to be non-inferior to the PPI-BQT regimen and yielded higher eradication rates across all analysis populations (ITT, MITT, and PP). The overall frequency of adverse events (27.9% and 34.2%, <i>p</i> = 0.151) and compliance (93.7% and 94.6%, <i>p</i> = 0.686) were similar between PPI and P-CAB groups. Among the patients suspected of drug-induced fever (8.6% and 7.2%, <i>p</i> = 0.597), 82.9% experienced fever after administration of furazolidone for > 10 days. The eradication rates were not affected by prior choice of antibiotics and the number of treatment attempts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 14-day P-CAB-BQT therapy containing amoxicillin and furazolidone provided a satisfactory eradication rate and a good safety profile as res","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seokho Myeong, Donghoon Kang, Joon Sung Kim, Yu Kyung Cho, Hyeon Woo Yim, Jae Myung Park
Background
Helicobacter pylori eradication reduces gastric cancer risk, but the long-term impact in peptic ulcer patients, particularly those with gastric ulcers (GU), remains unclear.
Aims
To assess the long-term incidence of gastric cancer in patients with H. pylori-treated gastric ulcers compared to the general population and to patients with duodenal ulcers (DU).
Methods
Using Korea's National Health Insurance Service database, we identified patients aged ≥ 40 years with endoscopically and histologically confirmed peptic ulcers treated for H. pylori between 2005 and 2008. Follow-up continued until 2019. Standardized incidence ratios (SIRs) for gastric cancer were calculated by comparing incidence in the study cohorts with the age- and sex-matched general population.
Results
Among 166,260 eligible patients (median follow-up 9.2 years), 2630 (1.58%) developed gastric cancer (SIR, 1.20; 95% CI, 1.15–1.24; p < 0.001), with consistently elevated risks across all age groups. Although cancer incidence remained elevated up to 12 years, patients followed for ≥ 13 years exhibited a significantly reduced risk compared to the general population (SIR, 0.78; 95% CI, 0.60–0.99; p = 0.049). In a sensitivity analysis, duodenal ulcer patients (n = 46,602) showed a lower overall risk (SIR, 0.86; 95% CI, 0.78–0.94; p < 0.001), with significant reductions even before 13 years of follow-up.
Conclusions
Gastric ulcer patients remain at increased risk for gastric cancer following H. pylori treatment. However, this risk declines over time and may fall below that of the general population after 13 years. These findings support the need for long-term surveillance in this high-risk group.
{"title":"Long-Term Risk of Gastric Cancer After Helicobacter pylori Eradication in Gastric Ulcer Patients: A Nationwide Cohort Study in Korea","authors":"Seokho Myeong, Donghoon Kang, Joon Sung Kim, Yu Kyung Cho, Hyeon Woo Yim, Jae Myung Park","doi":"10.1111/hel.70057","DOIUrl":"https://doi.org/10.1111/hel.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> eradication reduces gastric cancer risk, but the long-term impact in peptic ulcer patients, particularly those with gastric ulcers (GU), remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess the long-term incidence of gastric cancer in patients with <i>H. pylori</i>-treated gastric ulcers compared to the general population and to patients with duodenal ulcers (DU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using Korea's National Health Insurance Service database, we identified patients aged ≥ 40 years with endoscopically and histologically confirmed peptic ulcers treated for <i>H. pylori</i> between 2005 and 2008. Follow-up continued until 2019. Standardized incidence ratios (SIRs) for gastric cancer were calculated by comparing incidence in the study cohorts with the age- and sex-matched general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 166,260 eligible patients (median follow-up 9.2 years), 2630 (1.58%) developed gastric cancer (SIR, 1.20; 95% CI, 1.15–1.24; <i>p</i> < 0.001), with consistently elevated risks across all age groups. Although cancer incidence remained elevated up to 12 years, patients followed for ≥ 13 years exhibited a significantly reduced risk compared to the general population (SIR, 0.78; 95% CI, 0.60–0.99; <i>p</i> = 0.049). In a sensitivity analysis, duodenal ulcer patients (<i>n</i> = 46,602) showed a lower overall risk (SIR, 0.86; 95% CI, 0.78–0.94; <i>p</i> < 0.001), with significant reductions even before 13 years of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Gastric ulcer patients remain at increased risk for gastric cancer following <i>H. pylori</i> treatment. However, this risk declines over time and may fall below that of the general population after 13 years. These findings support the need for long-term surveillance in this high-risk group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"30 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hel.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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