ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
This article is part of the Research TopicChronic Atrophic Gastritis: Pathogenesis, Diagnostic Challenges, and Gastric Cancer RiskView all 10 articles
Gastric Mucosal Change after the Eradication of Helicobacter pylori in patients at High Risk for Gastric Cancers
Provisionally accepted
Na Rae Lim
Woo Chul Chung*- St. Vincent's Hospital, The Catholic University of Korea, Suwon, Republic of Korea
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Background: Eradication of Helicobacter pylori alone will not eliminate the risk of gastric cancer. There was no conclusive evidence that eradication therapy reduced the incidence of gastric cancer in patients with atrophic gastritis or intestinal metaplasia. Materials and Method: This study was conducted from March 2010 to September 2022, and enrolled 1,789 consecutive patients who underwent endoscopic submucosal dissection for gastric mucosal dysplasia. Patients who underwent two or more procedures for simultaneous or metachronous gastric epithelial dysplasia as high-risk groups for gastric cancer, and were confirmed to have H. pylori infection at the time of the procedure were included. Patients who received eradication treatment and underwent endoscopic follow-up for at least 2 years were included. The control group included patients who underwent endoscopic treatment for simple low-grade dysplasia. We investigated whether endoscopy was performed between 1 and 2 years after successful eradication of H. pylori. The endoscopic findings investigated were diffuse atrophy (open type), fundal atrophy, map-like redness, patch redness, erosions (body/antrum), hematin, endoscopic reflux esophagitis, hematin, and duodenitis. Results: In univariate analysis, diffuse atrophy, map-like redness, and patchy redness at antrum after H. pylori eradication were statistically different. In multivariate analysis, map-like redness (P< 0.01, 95% confidence interval (CI) 1.83-7.59) and patchy redness at antrum (P=0.02, 95% CI 1.11-4.74) observed were statistically more frequent in patients with synchronous-metachronous gastric dysplasia. Conclusion: Map-like redness and patchy redness are newly identified endoscopic risk factors for gastric cancer in patients treated for H. pylori eradication.
Keywords: gastric cancer, Helicobacter pylori, Eradication therapy, Endoscopic Submucosal Dissection, Metachronous gastric cancer
Received: 04 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Lim and Chung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Woo Chul Chung, jwchulkr@catholic.ac.kr
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