Effect of Helicobacter pylori eradication on gastric cancer risk in patients with intestinal metaplasia or dysplasia: a meta-analysis of randomized controlled trials

作者：Qiang Fu, Huidong Yu, Ming Liu, Liang Chen, Weiyang Chen, Ziyi Wang, Wenya Li · 发表于：Frontiers in Microbiology · 年份：2025 · DOI：10.3389/fmicb.2025.1530549 · 被引用次数：12 · 研究领域：Helicobacter pylori-related gastroenterology studies、Gastric Cancer Management and Outcomes、Microscopic Colitis

Background Observational studies suggest that Helicobacter pylori ( H. pylori ) is associated with an increased risk of gastric cancer, yet the effect of H. pylori eradication on gastric cancer risk in patients with intestinal metaplasia (IM) or dysplasia remains controversial. The purpose of this study was to summarize the evidence from randomized controlled trials (RCTs) investigating H. pylori eradication on gastric cancer risk in patients with IM or dysplasia to determine the evidence base. Methods PubMed, Embase, Cochrane Library, Web of science and China National Knowledge Internet database were searched for RCTs published through May 2024 in adults with IM or dysplasia comparing the risk of gastric cancer following H. pylori eradication versus no eradication therapy. Relative risk (RR) with its 95% confidence interval (CI) using random-effects model were employed for the effect estimate. Sensitivity, meta-regression, and subgroup analyses were also calculated. Results Sixteen RCTs involving 15,027 patients with IM or dysplasia met the inclusion criteria. In a pooled analysis, H. pylori eradication resulted in a 45% reduction in RR for gastric cancer risk relative to no eradication (RR: 0.55; 95% CI: 0.46–0.67; p < 0.001). H. pylori eradication significantly reduced the risk of gastric cancer in patients with dysplasia (RR: 0.51; 95% CI: 0.32–0.82; p = 0.005), and IM (RR: 0.61; 95% CI: 0.40–0.93; p = 0.022). Further, if the study conducted in countries other than...