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Protective role of Helicobacter pylori infection in prognosis of gastric cancer: evidence from 2,454 patients with gastric cancer.

Wang F, Sun G, Zou Y, Zhong F, Ma T, Li X - PLoS ONE (2013)

Bottom Line: There was no evidence of publication bias.This meta-analysis suggests a protective role for H. pylori infection in the prognosis of GC.The underlying mechanisms need to be further elucidated, which could provide new therapeutic approaches for GC.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

ABSTRACT

Background: A number of studies have investigated the association between Helicobacter pylori (H. pylori) infection and the prognosis of gastric cancer (GC), with inconsistent and inconclusive results. We performed a meta-analysis to derive a more precise estimation of the association.

Methodology/principal findings: A systematic search of PubMed, EMBASE, Cochrane and Chinese wanfang databases was performed with the last search updated on February 19, 2013. The hazard ratio (HR) and its 95% confidence interval (95%CI) were used to assess the strength of association. A total of 12 studies including 2454 patients with GC were involved in this meta-analysis. The pooled HR was 0.71 (95%CI: 0.57-0.87; P = 0.001) for OS and 0.60 (95%CI: 0.30-1.18; P = 0.139) for DFS in GC patients, respectively. The protective role of H. pylori infection in the prognosis of GC was also observed among different subgroups stratified by ethnicity, statistical methodology, H. pylori evaluation method and quality assessment. There was no evidence of publication bias.

Conclusions/significance: This meta-analysis suggests a protective role for H. pylori infection in the prognosis of GC. The underlying mechanisms need to be further elucidated, which could provide new therapeutic approaches for GC.

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Related in: MedlinePlus

Forest plot showing the meta-analysis of hazard ratios estimates for overall survival in gastric cancer patients.
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pone-0062440-g002: Forest plot showing the meta-analysis of hazard ratios estimates for overall survival in gastric cancer patients.

Mentions: The main results of this meta-analysis and the heterogeneity test are presented in Table 2. Among the 12 studies eligible for pooling of OS data, 7 studies provided estimated HR associated with its 95%CI [8], [10]–[14], [16]. In the remaining studies, these data points were calculated from data presented [9], [15], [17] or reconstructed from survival curve [18], [19]. Figure 2 shows the forest plot of HR for OS from each study. The pooled HR for OS in GC patients was 0.71 (95%CI: 0.57–0.87; P = 0.001), with significant evidence of heterogeneity between the contributing studies (P<0.0001). The funnel plot of HR showed no evidence of publication bias from either Begg’s test (P = 0.999) or Egger’s test (P = 0.634), which was shown in Figure 3.


Protective role of Helicobacter pylori infection in prognosis of gastric cancer: evidence from 2,454 patients with gastric cancer.

Wang F, Sun G, Zou Y, Zhong F, Ma T, Li X - PLoS ONE (2013)

Forest plot showing the meta-analysis of hazard ratios estimates for overall survival in gastric cancer patients.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3646839&req=5

pone-0062440-g002: Forest plot showing the meta-analysis of hazard ratios estimates for overall survival in gastric cancer patients.
Mentions: The main results of this meta-analysis and the heterogeneity test are presented in Table 2. Among the 12 studies eligible for pooling of OS data, 7 studies provided estimated HR associated with its 95%CI [8], [10]–[14], [16]. In the remaining studies, these data points were calculated from data presented [9], [15], [17] or reconstructed from survival curve [18], [19]. Figure 2 shows the forest plot of HR for OS from each study. The pooled HR for OS in GC patients was 0.71 (95%CI: 0.57–0.87; P = 0.001), with significant evidence of heterogeneity between the contributing studies (P<0.0001). The funnel plot of HR showed no evidence of publication bias from either Begg’s test (P = 0.999) or Egger’s test (P = 0.634), which was shown in Figure 3.

Bottom Line: There was no evidence of publication bias.This meta-analysis suggests a protective role for H. pylori infection in the prognosis of GC.The underlying mechanisms need to be further elucidated, which could provide new therapeutic approaches for GC.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

ABSTRACT

Background: A number of studies have investigated the association between Helicobacter pylori (H. pylori) infection and the prognosis of gastric cancer (GC), with inconsistent and inconclusive results. We performed a meta-analysis to derive a more precise estimation of the association.

Methodology/principal findings: A systematic search of PubMed, EMBASE, Cochrane and Chinese wanfang databases was performed with the last search updated on February 19, 2013. The hazard ratio (HR) and its 95% confidence interval (95%CI) were used to assess the strength of association. A total of 12 studies including 2454 patients with GC were involved in this meta-analysis. The pooled HR was 0.71 (95%CI: 0.57-0.87; P = 0.001) for OS and 0.60 (95%CI: 0.30-1.18; P = 0.139) for DFS in GC patients, respectively. The protective role of H. pylori infection in the prognosis of GC was also observed among different subgroups stratified by ethnicity, statistical methodology, H. pylori evaluation method and quality assessment. There was no evidence of publication bias.

Conclusions/significance: This meta-analysis suggests a protective role for H. pylori infection in the prognosis of GC. The underlying mechanisms need to be further elucidated, which could provide new therapeutic approaches for GC.

Show MeSH
Related in: MedlinePlus