Abstract

Background: Several studies had shown that Helicobacter pylori infection is inversely associated with esophageal cancer. These studies had claimed that infection had associated with protective effect. However, other studies come out with different conclusion about the relationship, as a result, the issue has remained controversial.

Objective: The aim of this systematic review and mata-analysis was to examine the association between Helicobacter pylori infection and esophageal cancer.

Methods: We searched the PubMed, Cochrane library, Google scholar data bases. Meanwhile, we retrieved some articles from the references of selected articles. Case-control and cohort studies were included in this systematic review and meta-analysis up to December 2018.

Result: Eleven studies were included to this systematic review and mata-analysis and about 912 articles were retrieved from 8 countries and 6953 people were enrolled. The mean age the participants were 62 6.49. Summary odds ratios and 95% confidence intervals were calculated using the DerSimonian-Laird method. Qstatistics and I2 statistics were calculated to examine heterogeneity. Subgroup analyses were conducted via histological types. To assess publication bias, funnel plot, Begg’s test, Egger test, Trim and Fill, Contour enhanced funnel plot, cumulative meta-analysis and influential or sensitivity analysis were undertaken. 

A significant association was observed between Helicobacter pylori infection and esophageal carcinoma (OR: 0.6; 95% CI: 0.420.85) (I-squared=80.6%, p=0.000). In addition, after sub- group analysis by sub-types, an association was observed between esophageal adenocarcinoma and helicobacter pylori infection OR (95% CI) was 0.47 (0.3 – 0.75). However, statistical significance was not observed between esophageal squamous cell carcinoma and Helicobacter pylori infection (OR =0.68 (95% CI) was (0.42 – 1.09).

Conclusion: Our results suggests that an inverse association was observed between Helicobacter pylori infection and esophageal adenocarcinoma, however, statistical significance was not observed between Helicobacter pylori infection and esophageal squamous cell carcinoma. 

Keywords: Helicobacter pylori; Esophageal cancer; Adenocarcinoma; Squamous cell carcinoma; Colonization