Eradication Therapy to Prevent Gastric Cancer in Helicobacterpylori-Positive Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies.

We updated a meta-analysisof randomized controlled trials (RCTs) examining this issue.

我们更新了一项关于这个问题的随机对照试验（RCTs）的荟萃分析。

Methods

We searched the literature through October 4, 2024, identifying studies examining effect of eradication therapy on incidenceof gastric cancer in H pylori-positive adults without gastric neoplasia at baseline or H pylori-positive patients with gastric neoplasia undergoing endoscopic mucosal resection (EMR) in either RCTs or observational studies.

我们在2024年10月4日之前检索了文献，确定了研究根除治疗对基线时无胃肿瘤的幽门螺杆菌阳性成人胃癌发生率的影响，以及接受内镜下黏膜切除术（EMR）的幽门螺杆菌阳性胃肿瘤患者的影响，这些研究包括随机对照试验（RCTs）或观察性研究。

The control arm received placebo or no eradication therapy in RCTs and no eradication therapy in observational studies.

对照组在随机对照试验中接受了安慰剂或未进行根除治疗，在观察性研究中未进行根除治疗。

Follow-up was ≥2 years.

随访时间≥2年。

We estimated relative risks (RR) of gastric cancer incidenceand mortality.

我们估计了胃癌发病率和死亡率的相对风险(RR)。

Results

Eleven RCTs and 13 observational studies were eligible.

共有11项随机对照试验（RCTs）和13项观察性研究符合纳入标准。

For RCTs, RR of gastric cancer was lower with eradication therapy in healthy H pylori-positive individuals (8 RCTs, 0.64; 95% confidence interval[CI], 0.48-0.84) and H pylori-positive patients with gastric neoplasia undergoing EMR (3 RCTs, 0.52; 95% CI, 0.38-0.71).

对于随机对照试验（RCTs），在健康的幽门螺杆菌阳性个体中，胃癌的相对风险（RR）通过根除治疗降低（8项RCTs，0.64；95%置信区间[CI]，0.48-0.84），以及在进行内镜下黏膜切除术（EMR）的幽门螺杆菌阳性胃肿瘤患者中，胃癌的相对风险（RR）也通过根除治疗降低（3项RCTs，0.52；95%置信区间[CI]，0.38-0.71）。

RR of death from gastric cancer was lower with eradication therapy in healthy H pylori-positive individuals (5 RCTs, 0.78; 95% CI, 0.62-0.98).

在健康幽门螺杆菌阳性个体中，根除治疗的胃癌死亡相对风险较低（5项随机对照试验，0.78；95%置信区间，0.62-0.98）。

In observational studies, RR of future gastric cancer was lower with eradication therapy in H pylori-positive subjects without gastric neoplasia at baseline (11 studies, 0.56; 95% CI, 0.43-0.73) and H pylori-positive patients with gastric neoplasia undergoing EMR (2 studies, 0.19; 95% CI, 0.06-0.61).

在观察性研究中，对于基线时无胃肿瘤的幽门螺杆菌阳性受试者，根除治疗的未来胃癌相对风险较低（11项研究，0.56；95%置信区间，0.43-0.73）；对于接受内镜下黏膜切除术的幽门螺杆菌阳性胃肿瘤患者，根除治疗的胃癌相对风险也较低（2项研究，0.19；95%置信区间，0.06-0.61）。

Conclusions

This meta-analysisprovides further evidence that administering eradication therapy prevents gastric cancer in H pylori-positive individuals, with consistency in results among studies of different design.

这项荟萃分析进一步证明，对幽门螺杆菌阳性个体实施根除治疗可以预防胃癌，不同设计的研究结果一致。