Eradication of <b><i>Helicobacter pylori</i></b> Induces Immediate Regressive Changes in Early Gastric Adenocarcinomas

Abstract

Objective: Helicobacter pylori eradication is expected to prevent gastric cancer. However, morphological alterations after eradication often hinder accurate diagnosis. Therefore, we evaluated endoscopic and histological changes in gastric tumors after eradication of H. pylori in a time-dependent manner. Methods: We classified 144 cases of endoscopic submucosal dissection (ESD) of early gastric cancer into the following categories: (i) patients positive for H. pylori with no eradication history, (ii) patients positive for H. pylori who underwent ESD 2 months after eradication, (iii) patients negative for H. pylori with an eradication history of at least 6 months before ESD, and (iv) patients negative for H. pylori with an unknown history. We compared endoscopic and histological factors between the groups. Results: The characteristics of cancers positive for H. pylori were exploding shape, superficial high-grade atypical epithelium, and a surface proliferating zone. H. pylori eradication induced a series of endoscopic and histological changes, including shape ­depression, appearance of surface regenerative and lower-grade atypical epithelium, and a downward shift of the proliferative zone within a period as short as 2 months. Conclusion: H. pylori eradication rapidly causes cancer regression and leads to tumor shrinkage, diminished atypism, and shortened proliferative zone, resulting in drastic morphological changes.

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

“…We have to recognize that GCAE revealed representative endoscopic feature, namely a superficial depressed feature. 16,[21][22][23] In 2005, we reported the morphological alterations of gastric tumors after eradication therapy of H. pylori in a prospective intervention study. 24 Patients with a gastric tumor received eradication therapy and the features of the gastric tumors were re-examined.…”

Effects of activation of an alcohol metabolic gene, cigarette smoking, and alcohol intake on the incidence of metachronous gastric cancer in patients who underwent endoscopic resection for gastric cancer: A multicenter retrospective pilot study

“…Spontaneous eradication due to past antibiotic therapy may have been the underlying cause. Those patients were defined as patients with spontaneous HP eradication 19 …”

“…Those patients were defined as patients with spontaneous HP eradication. 19 Definitions of metachronous GC. All patients underwent endoscopic examinations at 1 year after ER and every 1 year thereafter.…”