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KMID : 0931320190190040215
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대한상부위장관.헬리코박터학회지
2019 Volume.19 No. 4 p.215 ~ p.219
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Effectiveness of Helicobacter pylori Eradication before Endoscopic Resection
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Ahn Ji-Yong
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Abstract
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Helicobacter pylori (H. pylori) infection can cause gastric dysplasia and cancer via chronic inflammatory changes in the gastric mucosa that may lead to gastric atrophy and intestinal metaplasia. Many epidemiologic studies have demonstrated the prophylactic effects of H. pylori eradication on gastric cancer, and H. pylori eradication after endoscopic resection of early gastric cancer may prevent the occurrence of metachronous gastric cancer or dysplasia. Despite insufficient data on the effect of H. pylori eradication on gastric dysplasia and cancer before endoscopic resection, some studies have shown that H. pylori eradication can induce the regression or slow the progression of some gastric dysplasia. Therefore, eradication therapy before endoscopic resection may be effective in selected cases of low-grade dysplasia. However, endoscopic resection should be considered as the first-line treatment in high-grade dysplasia or early gastric cancer owing to the potential morphologic changes to some dysplasia or cancer that can be incurred by the eradication process, which may make it difficult to perform a subsequent endoscopic procedure.
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KEYWORD
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Endoscopic mucosal resection, Endoscopic submucosal dissection, Helicobacter pylori, Stomach neoplasms
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