Characteristics and Early Diagnosis of Gastric Cancer Discovered after Helicobacter pylori Eradication

Abstract

The prevalence of gastric cancer after eradication (GCAE) is increasing dramatically in Japan. GCAE has characteristic features, and we must understand these features in endoscopic examinations. Differentiated cancer types were frequently found after eradication and included characteristic endoscopic features such as reddish depression (RD). However, benign RD can be difficult to distinguish from gastric cancer because of histological alterations in the surface structures (nonneoplastic epithelium or epithelium with lowgrade atypia [ELA]) as well as multiple appearances of RD. Recently, we clarified similar alterations in genetic mutations between ELA and gastric cancer, suggesting that ELA is derived from gastric cancer. Clinically, submucosal invasive cancer was frequently found in patients after eradication therapy even if they received annual endoscopic surveillance. We can improve the diagnostic ability using image-enhanced endoscopy with magnified observation.

Aberrant DNA Methylation Maker for Predicting Metachronous Recurrence After Endoscopic Resection of Gastric Neoplasms

“…Differentiated GCs are frequently found after H. pylori eradication, showing characteristic endoscopic features such as reddish depression; benign reddish depression is difficult to be distinguished from GC because of the histological alterations in the surface structures (non-neoplastic epithelium or epithelium with low-grade atypia) as well as multiple appearances of benign reddish depression [ 22 ]. Furthermore, submucosal invasive cancers were not infrequently found after H. pylori eradication despite of the annual endoscopic surveillance [ 22 ]. In this study, all cases of metachronous recurrence (n=20) were either gastric dysplasia or EGC; six of seven metachronous gastric cancers (85.7%) were differentiated gastric cancers, but three cases (42.9%) invaded submucosa.…”

“…characteristic endoscopic features such as reddish depression; benign reddish depression is difficult to be distinguished from GC because of the histological alterations in the surface structures (non-neoplastic epithelium or epithelium with low-grade atypia) as well as multiple appearances of benign reddish depression [22]. Furthermore, submucosal invasive cancers were not infrequently found after H. pylori eradication despite of the annual endoscopic surveillance [22]. In this study, all cases of metachronous recurrence (n=20) were either gastric dysplasia or EGC; 6 of 7 metachronous gastric cancers (85.7 %) were differentiated gastric cancers, but 3 cases (42.9 %) invaded submucosa.…”

Survival-associated alternative splicing events interact with the immune microenvironment in stomach adenocarcinoma

“…Early clinical signs and symptoms of STAD might include continuous upper abdominal pain, heartburn, loss of appetite, emesis, and nausea; however, these nonspecific clinical manifestations commonly result in misdiagnosis of STAD[ 20 ]. Most STAD patients progress to advanced stages with symptoms including yellowing of the skin and the whites of the eyes, vomiting, difficulty in swallowing, malnutrition, weight loss, intolerable pain, and blood in the stool[ 21 ].…”

Endoscopic Treatment of Superficial Gastric Cancer: Present Status and Future

“…However, the possibility that H. pylori eradication may impede early detection of GC has also been suggested, with a significantly higher prevalence of EGC with submucosal invasion after H. pylori eradication compared to the non-eradicated group [ 63 ]. For these reasons, regular endoscopy is important after H. pylori eradication, but establishing a useful method for detecting EGC after H. pylori eradication is an issue [ 64 ].…”