Helicobacter pylori Infection and Oesophageal Cancer Risk: Association Studies via Evidence-based Meta-analyses

Zhuo, Xianlu; Zhang, Yao; Wang, Yan; Zhuo, Wenlei; Zhu, Yi; Zhang, Xueyuan

doi:10.1016/j.clon.2008.07.005

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Volume 20, Issue 10 , Pages 757-762, December 2008

Helicobacter pylori Infection and Oesophageal Cancer Risk: Association Studies via Evidence-based Meta-analyses1

Xianlu Zhuo
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
Yao Zhang
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
Yan Wang
- Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, China
Wenlei Zhuo
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, China
- Author for correspondence: Wenlei Zhuo, Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037 China. Tel/Fax: +86-23-68754405.
Yi Zhu
- College of Food Science and Nutritional Engineering, China Agriculture University, Beijing, China
Xueyuan Zhang
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
- Author for correspondence: Xueyuan Zhang, Department of Otolaryngology, Southwest Hospital,Third Military Medical University, Chongqing, 400038 China. Tel/Fax: +86-23-68754405.

Received 21 December 2007; received in revised form 21 July 2008; accepted 29 July 2008.

Abstract

Aims

Infection of Helicobacter pylori, a major cause of various gastric diseases, has been reported to play a role in the process of tumorigenesis and progression of gastric carcinoma. Some studies have been devoted to the relationship between H. pylori infection and oesophageal cancer and have yielded conflicting results. Whether infection of H. pylori is a risk factor for this cancer remains uncertain. In this study we aimed to evaluate the association of H. pylori infection with oesophageal cancer risk.

Materials and methods

The associated literature was acquired through deliberate searching and selected based on the established inclusion criteria for publications, then the extracted data were further analysed by systematic meta-analyses.

Results

In total, 195 articles were identified, of which 12 case–control studies concerning oesophageal cancer were selected. Oesophageal adenocarcinoma risk for H. pylori infection was 0.58-fold (95% confidence interval 0.48–0.70) (Z=5.79, P<0.01) compared with the controls. Oesophageal squamous cell carcinoma risk was 0.80-fold (95% confidence interval 0.45–1.43) (Z=0.75, P>0.05) compared with the controls. Compared with CagA-negative H. pylori, CagA-positive H. pylori markedly decreased oesophageal cancer risk.

Conclusion

The pooled data suggest infection of H. pylori as a possible preventive factor for oesophageal adenocarcinoma and failed to suggest a significant association between H. pylori infection and oesophageal squamous cell carcinoma.

Key words: Helicobacter pylori, meta-analysis, oesophageal adenocarcinoma, oesophageal squamous cell carcinoma, risk