New ideas for future studies of Helicobacter pylori

Gastric cancer (GC) is one of the inflammation-associated cancers. Helicobacter pylori is now thought to be responsible for more than 95% of all GCs, and its development is associated with at least four mechanisms that lead to genetic instability of the gastric mucosa. The risk of developing GC can be predicted by assessing the extent and severity of corpus atrophy and the degree of risk can be estimated by using non-invasive methods such as the pepsinogen test, or endoscopic or histological cancer risk scoring systems such as the operative link for gastritis assessment. The eradication of H. pylori will stop the progression of gastritis, prevent atrophy and thus decrease the risk of cancer. H. pylori eradication should follow the dictum "use what works best locally". There are several new developments in the diagnosis and treatment of H. pylori infection including serological antibody, fluorescent in situ hybridization and antibiotic resistance tests. It is still necessary to develop a preventive or therapeutic vaccine to prevent GC.