本研究旨在提供幽门螺杆菌 (H. pylori) 感染与胃癌 (GC) 发展之间关联强度的汇总、最新估计。我们检索了 1990 年至 2021 年 12 月的 PubMed、Embase 和 Cochrane 图书馆，以确定前瞻性研究研究，即巢式病例对照或病例队列研究。汇总比值比 (OR) 和 95% 置信区间 (CI)，以验证幽门螺杆菌感染与 GC 之间的关系。评估异质性和发表偏倚，并进行亚组随机效应荟萃分析。总共纳入 27 项研究。在欧洲/北美（OR = 5.37，95%CI：4.39-6.57）和亚洲（OR = 2.50，95%CI：1.89-3.32），幽门螺杆菌感染与非贲门胃癌（NCGC）密切相关。 ）。在亚洲，幽门螺杆菌感染与贲门胃癌 (CGC) 呈正相关（OR = 1.74，95%CI：1.38-2.19），但在欧洲/美洲人群中则不然，这种关联呈负相关（OR = 0.64，95） %CI：0.51 至 0.79）。此外，在亚洲的 NCGC 和 CGC 中，通过免疫印迹检测幽门螺杆菌的研究与 ELISA 相比，关联强度更大，而且在癌症诊断之前测试幽门螺杆菌检测的研究中，关联强度也更大。趋势<0.05）。亚洲约 79% 的 NCGC、欧洲/北美 87% 的 NCGC 以及亚洲 62% 的 CGC 可归因于幽门螺杆菌感染。这项荟萃分析总结了幽门螺杆菌感染与幽门螺杆菌感染之间关联的前瞻性证据。 GC，为针对幽门螺杆菌的 GC 预防计划的可归因风险和潜在影响提供可靠的估计。CRD42021274120。

The present study aimed to provide pooled, updated estimates of the strength of the association between Helicobacter pylori (H. pylori) infection and gastric cancer (GC) development.We searched PubMed, Embase, and Cochrane Library from 1990 to December 2021 to identify prospective studies, i.e. nested case-control or case-cohort studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were summarized to validate the relationship between H. pylori infection and GC. Heterogeneity and publication bias were assessed and random-effects meta-analyses by subgroup were performed.A total of 27 studies were included. H. pylori infection was strongly associated with non-cardia gastric cancer (NCGC) both in Europe/North America (OR = 5.37, 95%CI:4.39-6.57) and in Asia (OR = 2.50, 95%CI:1.89-3.32). H. pylori infection was also positively associated with cardia gastric cancer (CGC) in Asia (OR = 1.74, 95%CI:1.38-2.19), but not in European/American populations, where the association was inverse (OR = 0.64, 95%CI: 0.51 to 0.79). Furthermore, the strength of association was greater in studies that detected H. pylori by immunoblotting in comparison to ELISA, both for NCGC and for CGC in Asia, and also in studies testing for H. pylori detection further back in time prior to cancer diagnosis (Ptrend <0.05). Approximately 79% of NCGC in Asia, 87% of NCGC in Europe/North America, and 62% of CGC in Asia could be attributable to H. pylori infection.This meta-analysis summarizes prospective evidence for the association between H. pylori infection and GC, providing robust estimates for the attributable risk and potential impact of H. pylori-targeting GC prevention programs.CRD42021274120.