Helicobacter pylori as a protective factor for esophageal squamous cell carcinoma

ABSTRACT

A wide variety of epidemiological studies suggest the increase in incidence of esophageal adenocarcinoma which, in turn, might be related to decrease in Helicobacter pylori prevalence, but very few studies have examined this association .The aim of this study was therefore to evaluate the relationship between H.pylori and esophageal squamous-cell carcinoma in Urmia in a period of 30 months. In this case-control study 161 patients with pathologically proven esophageal squamous-cell carcinoma were enrolled. Subjects were cancer cases, pathologically proven to have esophageal squamous-cell carcinoma, in medical centers in Urmia in the west of Iran during a 30-months period in 2006 -2007 .Control cases [168 patients] were selected from the patients who were admitted to the ophthalmology department and were matched for sex, age and history of smoking. H .pylori seropositivity was determined by ELISA, using Trinity Biptech capita measuring IgG .Data were analyzed using Chi square and Mantel Hanzel tests. The mean age of patients with esophageal cancer was 61.8[SD=13.4] years. Sixty eight[42.2%] of patients were male and 93[57.8%]were female. In 31[19.2%] cases tumor ware located in the upper, 73 [45.3%] cases in middle and in remaining 57[35.4%] cases in the lower portion of the esophagus. A total of 69 [42.8%] and 105[62.5%] out of 161 cases and 168 controls, respectively, had positive H. pylori infection. Subjects with positive H .pylori infections had a significantly reduced risk [OR= 0.45; 95% CI= 0.28-0.72; P=0.0001] of developing esophageal SCC than those without SCC. Our findings suggest that H .pylori infection may have a protective role against development of esophageal SCC in our area .Additional studies are needed to confirm these findings: