Helicobacter pylori, are you still hesitating to sterilize?

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Helicobacter pylori, are you still hesitating to sterilize?

2018-10-25 20:25:45 131 ℃

Do you need bactericidal for H. pylori Hp? There are many patients and even many doctors (including some digestive doctors) are hesitant, whether it is necessary to sterilize, and whether the benefits of sterilization have recently been seen. We have seen the most authoritative voice in academia: Summarize a sentence: there is Hp infection, as long as there are conditions Must kill!

Of course, just recognizing the importance of sterilization is not enough, many patients It took a lot of energy and money, but the result was sterilization failure! Apart from the fact that individual patients are due to bacterial mutations and special resistance, most of the sterilization schemes used are relatively old. For example, the clarithromycin that is preferred in the classic sterilization program is highly resistant in many parts of China. Once the sterilization fails, in order to protect the liver and restore the sensitivity of the bacteria to the drug, it takes 3 months to resterilize.

Helicobacter pylori is the leading cause of gastric cancer

Helicobacter pylori infection is necessary, but not sufficient, in the development of Helicobacter pylori-associated gastric cancer, conceptually similar to hepatitis B and hepatitis C virus and human papillomavirus. Infection is necessary for the development of gastric cancer, but H. pylori infection alone is insufficient for gastric cancer formation and includes other factors. However, Helicobacter pylori is not the only cause of gastric cancer, and other rare causes account for 3% to 5% of gastric cancer, including EB virus infection, porcine genetic abnormalities, autoimmune gastritis, and possibly esophageal adenomas. Therefore, even without Helicobacter pylori, gastric adenocarcinoma is almost the same, not all disappear.

The ability to eradicate Helicobacter pylori to prevent gastric cancer formation depends on the patient The level of cancer risk when eradicating Helicobacter pylori. Patients with non-atrophic gastritis can expect complete or near complete protection. Patients with irreversible changes in gastric mucosa are at high risk, but they can be guaranteed that their risk is no longer increased and may be reduced. Risk stratification can also identify patients who may benefit from the secondary cancer prevention after eradication of H. pylori. The benefits of eradication of Helicobacter pylori also apply to patients at high risk of cancer death, such as patients with early gastric cancer (constrained to gastric mucosa and submucosal gastric cancer, with or without local lymph node metastasis). Successful removal of early gastric tumors under endoscopy, but in patients with Helicobacter pylori infection, the risk of metachronous gastric cancer is 1% to 4% per year, and eradication of Helicobacter pylori reduces the risk by about 3 times.

Evidence from eradication of Helicobacter pylori to reduce the risk of gastric cancer raises doubts: eradication What does Helicobacter pylori accomplish? How to best use this knowledge. Helicobacter pylori promotes the formation of gastric cancer, which leads to genetic instability of gastric epithelial cells through persistent acute and chronic inflammation and changes in genes and gene phenotypes. During tumor progression, gastric cancer cells acquire the ability to evade immune damage, have been immune, and begin to invade surrounding tissues. Helicobacter pylori and other members of the gastric microbiota. The interaction of endogenous and exogenous factors can also produce carcinogenic substances in the stomach. Environmental factors, especially diet, are important determinants of population risk (for example, different diets or food preservation methods can affect the severity of gastric mucosal and cancer risk caused by Helicobacter pylori).

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