The understanding
on the important role played by Helicobacter Pylori (HP) infection in
pathogenesis of gastric cancer (GC) and peptic ulcer disease has increased
progressively since the discovery of the bacteria in 1984 by Marshall and
Warren.
According to the
current concepts, GC develops from HP-infection through precursor lesions of
progressively increasing severity: mild, moderate and severe atrophic gastritis
(AG), accompanied by intestinal metaplasia (IM) and dysplasia. This sequence of
events is generally known as the “Correa cascade”, and estimated to
be involved in around 50% of GC cases, particularly the intestinal type of GC.
In parallel with
the increased understanding of the pathogenetic mechanisms, also the management
of HP- infection has undergone substantial development during the past decade. In
this context, the term management also covers the complex topics related to the
diagnosis of HP-infections. Much of this favourable development can be
attributed to the European Helicobacter Study Group that took its first
initiative in 1996 in Maastricht to gather dedicated experts to review all
relevant clinical data to draft the recommendations for the clinical management
of HP-infection.
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