[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-371931-105":59,"doc-detail-371931-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","helicobacter-pylori-infection-status-and-evolution-of-gastric-cancer-review-article","Helicobacter pylori infection status and evolution of gastric cancer - Review Article","","Gastric cancer (GC) remains highly prevalent and deadly, with a particularly heavy burden in China. Helicobacter pylori (H. pylori), classified as a Group I carcinogen, shows strong epidemiologic links to GC, yet only a small fraction of infected individuals develop GC and some develop it years after eradication. GC also arises in individuals never infected with H. pylori, while the share of H. pylori-negative GC is increasing as eradication rates decline. This review examines H. pylori virulence and host factors, including genetic susceptibility, immune microenvironment, co-infections, autoimmune gastritis, bile reflux, genetic mutations, and environmental influences, aiming to clarify mechanisms and identify high-risk groups.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/helicobacter-pylori-infection-status-and-evolution-of-gastric-cancer-review-article/371931/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/helicobacter-pylori-infection-status-and-evolution-of-gastric-cancer-review-article/371931.png","ImageObject",300,407,{"name":92,"@type":93},"PakDamar76","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why does H. pylori infection not always lead to gastric cancer?","Question",{"text":113,"@type":114},"Only about 3% of individuals with H. pylori infection eventually develop gastric cancer, and about 2.6% still progress 10–20 years after eradication, indicating that additional host and pathogenic mechanisms are required.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What factors may contribute to H. pylori-negative gastric cancer?",{"text":118,"@type":114},"Potential factors include infections by other microorganisms (bacteria, fungi, viruses), autoimmune gastritis, bile reflux, genetic mutations, and environmental factors.",{"name":120,"@type":111,"acceptedAnswer":121},"How does H. pylori eradication influence gastric cancer risk?",{"text":122,"@type":114},"Large-scale community evidence in China indicates successful eradication reduces gastric cancer incidence, and after over 20 years, eradication can reduce risk by 43%.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},371931,1790263978,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},962090893057,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Review Article  \nHelicobacter pylori infection status and evolution of gastric cancer  \nWenlin Zhang1, Yuxin Zhang2, Jing Ning2, Weiwei Fu2, Shigang Ding1  \n1Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China;  \n2Beijing Key Laboratory for Helicobacter Pylori Infection and Upper Gastrointestinal Diseases (BZ0371), Beijing 100191, China.  \nAbstract  \nGastric cancer (GC) is a globally prevalent malignancy with a particularly heavy burden in China. Helicobacter pylori (H. pylori) is a Group I carcinogen for GC, with a higher seroprevalence rate indicating a higher GC incidence. However, only approximately 3% of the individuals with H. pylori infection eventually develop GC, and about 2.6% still progress to GC even 10–20 years after the eradication of H. pylori. Thus, the pathogenic mechanism of H. pylori for GC must be elucidated, and high-risk individuals precisely identified. Furthermore, GC can occur even in individuals who have never been infected with H. pylori. As H. pylori infection rates decline, the proportion of H. pylori-negative GC cases is increasing annually, gaining significant research attention. In this review, potential pathogenic mechanisms of H. pylori infection are explored from the aspects of H. pylori virulence factors and host factors (genetic susceptibility and immune microenvironment) . Possible risk factors for H. pylori-negative GC include infections by other microorganisms (e.g., bacteria, fungi, and viruses), autoimmune gastritis, bile reflux, genetic mutations, and environmental factors. We aim to review the potential mechanisms for GC with varying H. pylori infection statuses, identify the high-risk individuals, and pose questions that need to be addressed. In the future, as the prevalence of H. pylori infection gradually decreases, GC prevention and management must evolve to address host-specific factors and the growing challenge of H. pylori-negative GC by integrating multidisciplinary perspectives.  \nKeywords: Gastric cancer; Helicobacter pylori; Host susceptibility; Gastric microbiota; Autoimmune gastritis; Bile reflux; Inflammation-cancer transformation  \nIntroduction  \nGastric cancer (GC) is a globally prevalent malignancy that poses a severe threat to human health. GC ranks in the top five malignancies in both incidence and mortality, accounting for 4.9% of all cancer cases and 6.8% of all cancer-related deaths globally. Approximately 1 million new GC cases are diagnosed annually worldwide, with more than 650,000 attributable deaths. [1] Notably, China has a particularly heavy GC burden. In 2024, approximately 232,310 new GC cases and 171,388 deaths were recorded in China. [2] Thus, clarifying the risk factors and pathogenesis of GC is crucial for early diagnosis and treatment.  \nHelicobacter pylori (H. pylori) is classified by the World Health Organization as a Group I carcinogen and has a crude global prevalence of over 50% . Globally, nearly 90% of non-cardia GC cases are associated with H. pylori infection. [3,4] Regions with a high incidence of GC, such as South Korea, China, and Japan, tend to have higher H. pylori seroprevalence rates. In China, 78.5% of non-cardia  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code: | Website:\u003Cbr>[www.cmj.org](www.cmj.org) |\n|  | DOI:\u003Cbr>10.1097/CM9.0000000000003903 |\n\nGC and 62. 1% of cardia GC cases are attributable to H. pylori infection. [5] H. pylori eradication is important for GC prevention. A large-scale study based on the community in China demonstrated that successful eradication reduces GC incidence, whereas failed eradication cases did not show this trend. [6] Specifically, H. pylori eradication can reduce the risk of GC by 43% after over 20 years. [7] In recent decades, the global incidence and mortality rates of GC have shown a consistent decline in both sexes, similar to the declining trend of H. pylori prevalence. [1,3,4] However, the correlation between H. pylori and GC is not","cbCaibzaVBmYl5YB","https://ap.wps.com/l/cbCaibzaVBmYl5YB","pdf",2088175,14,"English","# Introduction\n## Gastric cancer burden and risk factors\n## Helicobacter pylori as a carcinogen and epidemiologic associations","[{\"question\":\"Why does H. pylori infection not always lead to gastric cancer?\",\"answer\":\"Only about 3% of individuals with H. pylori infection eventually develop gastric cancer, and about 2.6% still progress 10–20 years after eradication, indicating that additional host and pathogenic mechanisms are required.\"},{\"question\":\"What factors may contribute to H. pylori-negative gastric cancer?\",\"answer\":\"Potential factors include infections by other microorganisms (bacteria, fungi, viruses), autoimmune gastritis, bile reflux, genetic mutations, and environmental factors.\"},{\"question\":\"How does H. pylori eradication influence gastric cancer risk?\",\"answer\":\"Large-scale community evidence in China indicates successful eradication reduces gastric cancer incidence, and after over 20 years, eradication can reduce risk by 43%.\"}]","Helicobacter pylori infection status and evolution of gastric cancer - Review Article | PDF",1790193255,35]