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Helicobacter Species and Hepato-Biliary Tract Malignancies: A Systematic Review and Meta-Analysis

2023; Multidisciplinary Digital Publishing Institute; Volume: 15; Issue: 3 Linguagem: Inglês

10.3390/cancers15030595

2072-6694

Beatriz Gros, Alberto Gómez Pérez, M. Pleguezuelo, Francisco Ruiz, Manuel de la Mata, Manuel Rodríguez‐Perálvarez,

Cholangiocarcinoma and Gallbladder Cancer Studies

Helicobacter species may cause chronic inflammation of the biliary tract, but its relationship with cancer is controversial. We performed a systematic review and meta-analysis to evaluate the association between Helicobacter species and hepatobiliary tract malignancies. Twenty-six studies (4083 patients) were included in qualitative synthesis, and 18 studies (n = 1895 qualified for meta-analysis. All studies were at high-intermediate risk of bias. Most studies combined several direct microbiological methods, mostly PCR (23 studies), culture (8 studies), and/or CLOtest (5 studies). Different specimens alone or in combination were investigated, most frequently bile (16 studies), serum (7 studies), liver/biliary tissue (8 studies), and gastric tissue (3 studies). Patients with Helicobacter species infection had an increased risk of hepatobiliary tract malignancies (OR = 3.61 [95% CI 2.18–6.00]; p < 0.0001), with high heterogeneity in the analysis (I2 = 61%; p = 0.0003). This effect was consistent when Helicobacter was assessed in bile (OR = 3.57 [95% CI 1.73–7.39]; p = 0.0006), gastric tissue (OR = 42.63 [95% CI 5.25–346.24]; p = 0.0004), liver/biliary tissue (OR = 4.92 [95% CI 1.90–12.76]; p = 0.001) and serum (OR = 1.38 [95% CI 1.00–1.90]; p = 0.05). Heterogeneity was reduced in these sub-analyses (I2 = 0–27%; p = ns), except for liver/biliary tissue (I2 = 57%; p = 0.02). In conclusion, based on low-certainty data, Helicobacter species chronic infection is associated with a tripled risk of hepatobiliary tract malignancy. Prospective studies are required to delineate public health interventions.