From histological recovery to residual gastric cancer risk after Helicobacter pylori eradication: a multi-database bibliometric and clinical decision-domain analysis.

Authors

Houshu Tu, Menglin Chen, Panpan Zhu, Jing Hong, Ling He

Published in

Frontiers in medicine. Volume 13. Pages 1962890. Epub Sep 23, 2026.

Abstract

Successful Helicobacter pylori eradication reduces gastric cancer risk, but residual risk persists in patients with established atrophy or intestinal metaplasia. We integrated multi-database science mapping with independent article-level clinical decision-domain classification to quantify how the research agenda evolved from mucosal recovery to residual-risk management and to identify decision-critical evidence gaps.
Web of Science, Scopus, and PubMed were searched through 27 July 2026. Records were deterministically deduplicated and independently screened. Bibliometric networks, thematic structure, temporal bursts, and cited-reference relationships were analyzed. Two reviewers independently classified each publication into one of five mutually exclusive clinical decision domains. Temporal distributions were compared using Pearson's chi-square test, and a research-priority framework was synthesized by triangulating the quantitative findings with representative clinical evidence.
Of 778 source records, 283 publications from 1993 to 2026 were included. Reviewer agreement was 78.80% (Cohen's kappa = 0.722). Histological regression and mucosal recovery predominated in 1993-2007 (34.7%), whereas surveillance and prevention (39.6%) and risk stratification (30.2%) became dominant in 2008-2017 and remained the leading domains in 2018-2026. Domain distributions differed significantly across periods (P = 0.008) and remained significant after exclusion of the incomplete 2026 publication year. The principal translational gaps were the absence of externally validated multimodal risk thresholds and comparative evidence defining surveillance eligibility, intervals, duration, and outcomes.
The field has shifted from asking whether gastric mucosal damage can recover to determining who remains at risk and how that risk should be managed. The resulting clinical decision taxonomy and research-priority framework support future validation of multimodal risk thresholds and comparative surveillance strategies; they do not establish universal surveillance or specific intervals.

PMID:
42845987
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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