[Meta-analysis on relationship between Helicobacter pylori infection and esophagogastric junction adenocarcinoma]

To systematically evaluate the etiological association between esophagogastric junction adenocarcinoma and Helicobacter pylori (Hp) infection and the pathogenicity of Cag pathogenic island in Hp infection cases.

Literatures about Hp infection and esophagogastric junction adenocarcinoma published from January 1980 to April 2015 were retrieved from CNKI, Wanfang data, VIP, the Cochrane Library, PubMed, EMBase databases. The literatures which met the inclusion criteria were collected and evaluated by using Newcastle-Ottawa Scale, then the heterogeneity was analyzed with Review Manager 5.3, and the pooled OR value and 95% confidence interval were calculated.

A total of 5547 study subjects were recruited in 13 studies, including 1446 esophagogastric junction adenocarcinoma cases and 4101 controls. The combined OR for Hp infection was 0.95 (95%CI: 0.66-1.36), P=0.71; The OR in high risk areas was 1.66 (95%CI: 1.33-2.08, P<0.001), higher than that in low-risk areas (0.68, 95%CI: 0.49-0.94, P=0.020). In addition, six studies found that the combined detection rates of Cag pathogenic island in esophagogastric junction adenocarcinoma cases and controls were 80.50% and 79.80%, respectively. There was no significant difference between two group, the combined OR was 1.24 (95%CI: 0.96-1.60).

The association between Hp infection and esophagogastric junction adenocarcinoma was not significant, however, the significant difference was observed between high risk area and low risk area; the detection rate of Gag pathogenic island in Hp infection cases was high, but the pathogenicity for esophagogastric junction adenocarcinoma needs further study.