Eficacia de la erradicación del Helicobacter pylori en la prevención del cáncer gástrico: revisión sistemática y metanálisis
Páramo Hernández, David B.
Rodríguez Sabogal, Iván Arturo
Toledo Arenas, Jose Daniel
Revista Colombiana de Gastroenterología, 0120-9957, Vol. 29, Nro. 3, 2014, p. 262-269
Asociaciones Colombianas de Gastroenterología
MetadataShow full item record
The aim of this systematic review and meta-analysis is to determine the effi cacy of eradicating Helicobacter pylori for prevention of gastric cancer. We conducted a literature review using major databases including PUBMED, EMBASE, CINAHL (EBSCO), Google Scholar, LILACS, Cochrane, ProQuest Dissertations and Theses. Seven experiments were selected out of the 3,934 references obtained by applying our inclusion and exclusion criteria. All seven were randomized controlled trials. The quality of the studies was assessed with the Cochrane assessment of risk of bias. Statistical analysis was performed with REVMAN 5.2. Out of a total of 5,552 subjects, 55 (2.41%) of the 2,278 patients who had had H. pylori eradicated developed gastric cancer, but 96 (4.22%) of the 2,272 patients who had not had the bacteria eradicated developed gastric cancer (RR: 0.57, CI = 0.42 to 0.79). Follow-up time ranged from 3 to 15 years. The analysis of heterogeneity (Chi square) had a non-signifi cant p value (p = 0.48) confi rming the absence of heterogeneity and allowing the meta-analysis. Funnel Plot analysis was used to discard publication bias, and the sensitivity analysis showed no signifi cant changes. In conclusion, this study suggests that eradication of H. pylori reduces the risk of gastric cancer, particularly in high-risk populations with medium quality evidence. We recommend the practice of using eradicate of H. pylori as a preventive measure.
- Artículos