Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.

<h4>Background</h4>Whether the characteristics and prognosis of gastric cancer (GC) are different in patients with and without Helicobacter pylori (HP) remains controversial. The definitions of HP status in patients with atrophic gastritis but negative tests for HP are heterogeneous. We...

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Main Authors: Kun-Feng Tsai, Jyh-Ming Liou, Mei-Jyh Chen, Chien-Chuan Chen, Sung-Hsin Kuo, I-Rue Lai, Kun-Huei Yeh, Ming-Tsan Lin, Hsiu-Po Wang, Ann-Lii Cheng, Jaw-Town Lin, Chia-Tung Shun, Ming-Shiang Wu, Taiwan Gastrointestinal Disease and Helicobacter Consortium
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0170942&type=printable
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author Kun-Feng Tsai
Jyh-Ming Liou
Mei-Jyh Chen
Chien-Chuan Chen
Sung-Hsin Kuo
I-Rue Lai
Kun-Huei Yeh
Ming-Tsan Lin
Hsiu-Po Wang
Ann-Lii Cheng
Jaw-Town Lin
Chia-Tung Shun
Ming-Shiang Wu
Taiwan Gastrointestinal Disease and Helicobacter Consortium
author_facet Kun-Feng Tsai
Jyh-Ming Liou
Mei-Jyh Chen
Chien-Chuan Chen
Sung-Hsin Kuo
I-Rue Lai
Kun-Huei Yeh
Ming-Tsan Lin
Hsiu-Po Wang
Ann-Lii Cheng
Jaw-Town Lin
Chia-Tung Shun
Ming-Shiang Wu
Taiwan Gastrointestinal Disease and Helicobacter Consortium
author_sort Kun-Feng Tsai
collection DOAJ
description <h4>Background</h4>Whether the characteristics and prognosis of gastric cancer (GC) are different in patients with and without Helicobacter pylori (HP) remains controversial. The definitions of HP status in patients with atrophic gastritis but negative tests for HP are heterogeneous. We aimed to assess the impact of HP on the prognosis of GC using different definitions.<h4>Methods</h4>From 1998 Nov to 2011 Jul, five hundred and sixty-seven consecutive patients with GC were included. HP status was determined by serology and histology. Patients with any positive test were defined as HP infection. Patients without HP infection whose serum pepsinogen (PG) I <70 ng/dl and PG I/II ratio < 3.0 were defined as atrophic gastritis and they were categorized into model 1: HP positive; model 2: HP negative; and model 3: exclusion of these patients.<h4>Results</h4>We found four characteristics of HP negative GC in comparison to HP positive GC: (1) higher proportion of the proximal tumor location (24.0%, P = 0.004), (2) more diffuse histologic type (56.1%, p = 0.008), (3) younger disease onset (58.02 years, p = 0.008) and (4) more stage IV disease (40.6%, p = 0.03). Patients with negative HP had worse overall survival (24.0% vs. 35.8%, p = 0.035). In Cox regression models, the negative HP status is an independent poor prognostic factor (HR: 1.34, CI:1.04-1.71, p = 0.019) in model 1, especially in stage I, II and III patients (HR: 1.62; CI:1.05-2.51,p = 0.026).<h4>Conclusion</h4>We found the distinct characteristics of HP negative GC. The prognosis of HP negative GC was poor.
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spelling doaj-art-27e4c2ebe3904715a4f868be0fe8e0ab2025-08-20T02:03:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017094210.1371/journal.pone.0170942Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.Kun-Feng TsaiJyh-Ming LiouMei-Jyh ChenChien-Chuan ChenSung-Hsin KuoI-Rue LaiKun-Huei YehMing-Tsan LinHsiu-Po WangAnn-Lii ChengJaw-Town LinChia-Tung ShunMing-Shiang WuTaiwan Gastrointestinal Disease and Helicobacter Consortium<h4>Background</h4>Whether the characteristics and prognosis of gastric cancer (GC) are different in patients with and without Helicobacter pylori (HP) remains controversial. The definitions of HP status in patients with atrophic gastritis but negative tests for HP are heterogeneous. We aimed to assess the impact of HP on the prognosis of GC using different definitions.<h4>Methods</h4>From 1998 Nov to 2011 Jul, five hundred and sixty-seven consecutive patients with GC were included. HP status was determined by serology and histology. Patients with any positive test were defined as HP infection. Patients without HP infection whose serum pepsinogen (PG) I <70 ng/dl and PG I/II ratio < 3.0 were defined as atrophic gastritis and they were categorized into model 1: HP positive; model 2: HP negative; and model 3: exclusion of these patients.<h4>Results</h4>We found four characteristics of HP negative GC in comparison to HP positive GC: (1) higher proportion of the proximal tumor location (24.0%, P = 0.004), (2) more diffuse histologic type (56.1%, p = 0.008), (3) younger disease onset (58.02 years, p = 0.008) and (4) more stage IV disease (40.6%, p = 0.03). Patients with negative HP had worse overall survival (24.0% vs. 35.8%, p = 0.035). In Cox regression models, the negative HP status is an independent poor prognostic factor (HR: 1.34, CI:1.04-1.71, p = 0.019) in model 1, especially in stage I, II and III patients (HR: 1.62; CI:1.05-2.51,p = 0.026).<h4>Conclusion</h4>We found the distinct characteristics of HP negative GC. The prognosis of HP negative GC was poor.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0170942&type=printable
spellingShingle Kun-Feng Tsai
Jyh-Ming Liou
Mei-Jyh Chen
Chien-Chuan Chen
Sung-Hsin Kuo
I-Rue Lai
Kun-Huei Yeh
Ming-Tsan Lin
Hsiu-Po Wang
Ann-Lii Cheng
Jaw-Town Lin
Chia-Tung Shun
Ming-Shiang Wu
Taiwan Gastrointestinal Disease and Helicobacter Consortium
Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.
PLoS ONE
title Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.
title_full Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.
title_fullStr Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.
title_full_unstemmed Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.
title_short Distinct Clinicopathological Features and Prognosis of Helicobacter pylori Negative Gastric Cancer.
title_sort distinct clinicopathological features and prognosis of helicobacter pylori negative gastric cancer
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0170942&type=printable
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