HELICOBACTER PYLORI FACTOR DE RIESGO PARA CÁNCER GÁSTRICO: UNA REVISIÓN SISTEMÁTICA: Helicobacter pylori as a Risk Factor for Gastric Cancer: A Systematic Review

Heidy Lisbeth Villavicencio Boyer

doi:10.57188/ricsa.2025.032

Authors

Heidy Lisbeth Villavicencio Boyer Escuela de Medicina Humana, Universidad Nacional de Tumbes, Tumbes, Perú. https://orcid.org/0000-0001-7243-2150 (unauthenticated)

DOI:

https://doi.org/10.57188/ricsa.2025.032

Keywords:

Helicobacter pylori, Stomach Neoplasms, Carcinogenesis, Primary Prevention, Endoscopy, Digestive (Source: DeCS-BIREME)

Abstract

Introduction: Helicobacter pylori infection is a major modifiable risk factor for gastric cancer, involved in the progression from chronic gastritis to preneoplastic lesions and carcinoma. Materials and methods: A narrative review with partial systematization was conducted. Literature searches were performed in PubMed, Scopus, SciELO, and Google Scholar using MeSH and DeCS terms related to H. pylori, gastric cancer, carcinogenesis, and eradication. A total of 137 studies were identified; 107 full-text articles were screened, and 31 were included based on predefined PICO criteria. Study selection was organized through Rayyan®. Results: Evidence indicates that H. pylori infection significantly increases gastric cancer risk, with estimates exceeding a 2.5-fold increase. Virulent strains such as cagA+ confer an even higher risk. Mechanisms implicated include chronic inflammation, atrophy, intestinal metaplasia, epigenetic alterations, and activation of oncogenic pathways. Early eradication reduces progression to preneoplastic stages and is considered a cost-effective preventive strategy. Endoscopy and emerging biomarkers provide valuable tools for surveillance of high-risk individuals. Conclusion: H. pylori plays a central role in gastric carcinogenesis. Targeted eradication and risk-based surveillance strategies are essential to reduce the burden of gastric cancer, particularly in high-incidence regions. Further longitudinal studies are required to optimize prevention and follow-up protocols.

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References

1. Frèche B, Salvan J, Roch MC, Guerin A, Poupin E, Pichon M, et al. Diagnostic and Therapeutic Management of Helicobacter pylori Infection in Primary Care: Perspective of Application in France and Narrative Review of the Literature. Healthc. 2023;11(3).

2. Kowada A. A Population-Based Helicobacter pylori Eradication Strategy Is More Cost-Effective than Endoscopic Screening. Dig Dis Sci. 2023;68(5):1735-46.

3. Januszewicz W, Turkot MH, Malfertheiner P, Regula J. A Global Perspective on Gastric Cancer Screening: Which Concepts Are Feasible, and When? Cancers (Basel). 2023;15(3):1-11.

4. Kim JL, Kim SG, Natsagdorj E, Chung H, Cho S-J. Helicobacter pylori Eradication Can Reverse Rho GTPase Expression in Gastric Carcinogenesis . Gut Liver. 2023;

5. Correa P, Piazuelo MB. Evolutionary history of the Helicobacter pylori genome: Implications for gastric carcinogenesis. Gut Liver. 2012;6(1):21-8.

6. Torres J, Correa P, Ferreccio C, Hernandez-Suarez G, Herrero R, Cavazza-Porro M, et al. Gastric cancer incidence and mortality is associated with altitude in the mountainous regions of Pacific Latin America. Cancer Causes Control. 2013;24(2):249-56.

7. Espejo Romero H, Navarrete Siancas J. Clasificación de los Adenocarcinomas de estómago. Rev Gastroenterol Perú. 2003;23:199-212.

8. Fock KM. Review article: The epidemiology and prevention of gastric cancer. Aliment Pharmacol Ther. 2014;40(3):250-60.

9. Jiménez Víquez M, Romero Castillo A, Brenes Zumbado MJ. Prevención del cáncer gástrico y erradicación de Helicobacter pylori. Rev Medica Sinerg. 2019;4(11):e293.

10. Abengozar R, Sharma A, Sharma R. Gastric cancer: Lessons learned from high-incidence geographic regions. J Gastrointest Oncol. 2021;12(2):S350-60.

11. Poorolajal J, Moradi L, Mohammadi Y, Cheraghi Z, Gohari-Ensaf F. Risk factors for stomach cancer: a systematic review and meta-analysis. Epidemiol Health. 2020;42:1-8.

12. Taniyama Y, Katanoda K, Charvat H, Hori M, Ohno Y, Sasazuki S, et al. Estimation of lifetime cumulative incidence and mortality risk of gastric cancer. Jpn J Clin Oncol. 2017;47(11):1097-102.

13. Pih GY, Gong EJ, Choi JY, Kim MJ, Ahn JY, Choe J, et al. Associations of Serum Lipid Level with Gastric Cancer Risk, Pathology, and Prognosis. Cancer Res Treat. 2021;53(2):445-56.

14. Xia HH-X. Association between Helicobacter pylori and gastric cancer: current knowledge and future research . World J Gastroenterol. 1998;4(2):93.

15. Martínez-Carrillo DN, Arzeta Camero V, Jiménez-Wences H, Román-Román A, Fernández-Tilapa G. Cáncer de estómago: factores de riesgo, diagnóstico y tratamiento. Alianzas y Tendencias BUAP. 2021;6(23):52-71.

16. Park DW, Lee KJ, Jin SH, Lee JH, Min JS, Park SH, et al. Phenotypic differences of gastric cancer according to the Helicobacter pylori infection in Korean patients. J Gastric Cancer. 2010;10(4):168-74.

17. Choi YJ, Kim N. Gastric cancer and family history. Korean J Intern Med. 2016;31(6):1042-53.

18. Baek SM, Kim N, Kwon YJ, Lee HS, Kim HY, Lee J, et al. Role of serum pepsinogen II and Helicobacter pylori status in the detection of diffuse-type early gastric cancer in young individuals in South Korea. Gut Liver. 2020;14(4):439-49.

19. Gao H-J, Lu X-Z, Zhang X-Y, Zhao Z-Q. AgNOR and rasp21 expression in gastric mucosal lesions caused by Helicobacter pylori infection . World J Gastroenterol. 1997;3(4):252.

20. Sampaio AM, Balseiro SC, Silva MR, Alarcão A, d’Aguiar MJ, Ferreira T, et al. Association between IL-4 and IL-6 expression variants and gastric cancer among portuguese population. GE Port J Gastroenterol. 2015;22(4):143-52.

21. Libânio D, Dinis-Ribeiro M, Pimentel-Nunes P. Helicobacter pylori and microRNAs: Relation with innate immunity and progression of preneoplastic conditions. World J Clin Oncol. 2015;6(5):111-32.

22. Lim JH, Kim SG, Choi JM, Yang HJ, Kim JS, Jung HC. Helicobacter pylori Is associated with mir-133a expression through promoter methylation in gastric carcinogenesis. Gut Liver. 2018;12(1):58-66.

23. Parsonnet J, Friedman GD, Orentreich N, Vogelman H. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut. 1997;40(3):297-301.

24. Cai H, Ye F, Michel A, Murphy G, Sasazuki S, Taylor PR, et al. Helicobacter pylori blood biomarker for gastric cancer risk in East Asia. Int J Epidemiol. 2016;45(3):774-81.

25. Roldán IJ, Castaño R, Navas MC. Mutaciones del gen ARN ribosómico 23S de Helicobacter pylori asociadas con resistencia a claritromicina en pacientes atendidos en una unidad de endoscopia de Medellín, Colombia. Biomedica. 2019;39:117-29.

26. Lee K, Hwang H, Nam KT. Immune response and the tumor microenvironment: How they communicate to regulate gastric cancer. Gut Liver. 2014;8(2):131-9.

27. Kwak JH, Eun CS, Han DS, Kim YS, Song KS, Choi BY, et al. Association between soy products, fruits, vegetables, and dairy products and gastric cancer risk in Helicobacter pylori-infected subjects: a case-control study in Korea. Nutr Res Pract. 2023;17(1):122-34.

28. Ohno A, Miyoshi J, Kato A, Miyamoto N, Yatagai T, Hada Y, et al. Endoscopic severe mucosal atrophy indicates the presence of gastric cancer after Helicobacter pylori eradication -analysis based on the Kyoto classification. BMC Gastroenterol. 2020;20(1):1-7.

29. Park BS, Lee SH. Eficacia clínica de la radioterapia en el linfoma primario del tejido linfoide asociado a la mucosa gástrica con Helicobacter pylori negativo o que no responde a la terapia de erradicación. 2019;73(1):19-25.

30. Asano N, Iijima K, Terai S, Uno K, Endo H, Koike T, et al. Signet ring cell gastric cancer occurring after radiation therapy for helicobacter pylori-uninfected mucosa-associated lymphoid tissue lymphoma. Case Rep Gastroenterol. 2011;5(2):325-9.

31. Pimentel-Nunes P, Libânio D, Marcos-Pinto R, Areia M, Leja M, Esposito G, et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Port. Endoscopy. 2019;51(4):365-88.

32. Xu G-M, Ji X-H, Li Z-S, Man X-H, Zhang H-F. Clinical significance of PCR in Helicobacter pylori DNA detection in human gastric disorders . World J Gastroenterol. 2011;3(2):98.

33. Sakr R, Massoud M, Aftimos G, Chahine G. Gastric adenocarcinoma secondary to primary gastric diffuse large B-cell lymphoma. J Gastric Cancer. 2017;17(2):180-5.

34. Ivyna de Araújo Rêgo R, Guedes Silvestre GF, Ferreira de Melo D, Albino SL, Pimentel MM, Silva Costa Cruz SB, et al. Flavonoids-Rich Plant Extracts Against Helicobacter pylori Infection as Prevention to Gastric Cancer. Front Pharmacol. 2022;13(August):1-20.

35. Wang T, Cai H, Sasazuki S, Tsugane S, Zheng W, Cho ER, et al. Fruit and vegetable consumption, Helicobacter pylori antibodies, and gastric cancer risk: A pooled analysis of prospective studies in China, Japan, and Korea. Int J Cancer. 2017;140(3):591-9.

Helicobacter pylori as a Risk Factor for Gastric Cancer: A Systematic Review