Intramucosal gastric adenocarcinoma of poorly differentiated type in the young is characterized by Helicobacter pylori infection and antral lymphoid hyperplasia

Hirahashi, Minako; Yao, Takashi; Matsumoto, Takayuki; Nishiyama, Ken Ichi; Oya, Masafumi; Iida, Mitsuo; Tsuneyoshi, Masazumi

doi:10.1038/modpathol.3800714

Cited by 29 publications

(30 citation statements)

References 24 publications

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“…Helicobacter pylori infection is strongly related to the development of gastric cancer in young patients [10, 11, 20, 21]. In the current study, younger patients showed a statistically significant higher risk of having H. pylori infection and the diffuse histological type of gastric carcinoma after multivariate analysis.…”

Section: Discussionsupporting

confidence: 48%

Gastric Cancer in the Young: Is It a Different Clinical Entity? A Retrospective Cohort Study

Pisanu

Podda

Cois

et al. 2014

Gastroenterology Research and Practice

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Background. The rate of gastric cancer in young patients has increased over the past few decades. The aim of this study was to search for independent risk factors related to patients of younger age. Methods. From January 1996 to December 2012, a series of 179 consecutive patients were admitted to our surgical department because of a gastric cancer. We carried out a retrospective cohort study in 20 patients younger than 50 and in 112 patients aged 50 and older treated by curative gastrectomy. The comparison involved the evaluation of patient and tumor characteristics. Results. Younger patients had significantly less comorbidities and a more favorable American Society of Anesthesiology score; they had significantly less preoperative weight loss and a significantly longer duration of symptoms; Helicobacter pylori infection and diffuse histological type were significantly associated with younger age. There was no statistically significant difference regarding overall and cancer-related 5-year survival; advanced cancer stage and diffuse histological type were the independent negative prognostic factors influencing cancer-related survival. Conclusions. We do not have sufficient evidence to consider gastric cancer in younger patients as a different clinical entity. Further studies are needed to understand carcinogenesis in younger patients and to improve gastric cancer classification.

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Section: Discussionsupporting

confidence: 48%

Gastric Cancer in the Young: Is It a Different Clinical Entity? A Retrospective Cohort Study

Pisanu

Podda

Cois

et al. 2014

Gastroenterology Research and Practice

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show abstract

“…As found in similar patient populations, the number of females was significantly higher in our young patient group compared to the older patients ( P < 0.01). In both groups, a large number of the lesions were located in the middle part of the stomach, with a median size of 3.8–3.9 cm.…”

Section: Methodssupporting

confidence: 84%

“…It should be noted that the accumulation of 8OHdG was already increased not only in the noncancerous mucosal neck cells but also in the noncancerous foveolar epithelial cells in both our young and older patients groups. H. pylori ‐induced chronic superficial gastritis (i.e., ‘nodular gastritis’) is accompanied and is associated with carcinogenesis in young patients . In contrast, older patients with gastric cancer generally have chronic atrophic gastritis .…”

Section: Discussionmentioning

confidence: 99%

Induced nitric oxide synthetase and peroxiredoxin expression in intramucosal poorly differentiated gastric cancer of young patients

Hirahashi

Koga

Kumagai

et al. 2014

Pathology International

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To investigate the relationship between oxidative stress and gastric carcinogenesis of poorly differentiated adenocarcinoma in young patients, we analyzed the surgically resected specimens of 22 young patients (21-30 years) and 29 older patients (41-72 years) with intramucosal gastric cancer of the poorly differentiated type. We used immunohistochemical staining to evaluate the expression of 8-hydroxydeoxyguanosine (8OHdG), induced nitric oxide synthetase (iNOS), and antioxidant enzymes (thioredoxin [TRX] and peroxiredoxin [PRDX1, 2 and 3]). We assessed these proteins in the cancer, noncancerous gastric foveolar epithelium and noncancerous mucosal neck. In both the young and older patient groups, the 8OHdG and TRX expressions were gradually increased in cancer cells compared with the noncancerous foveolar epithelial cells and the noncancerous mucosal neck cells (P < 0.001). Although the iNOS and PRDXs expressions were increased in the noncancerous mucosal neck cells compared with the noncancerous foveolar epithelial cells, regardless of age (P < 0.001), the iNOS and PRDX2 expression in the cancer cells were significantly reduced in the young patients compared with the older patients (P < 0.001, P < 0.05). In conclusion, the reduced expression of iNOS or PRDX2 may play an important role in the carcinogenesis of gastric cancer associated with Helicobacter pylori-induced chronic active gastritis in young patients.

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“…In 1994, the International Agency for Research on Cancer (IARC) accepted H. pylori as a definite carcinogen (group 1) that induces gastric carcinomas. Recently, the close relationship between H. pylori infection and the development of undifferentiated-type carcinomas has been demonstrated [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Re-evaluation of Histogenesis of Gastric Carcinomas: A Comparative Histopathological Study Between Helicobacter pylori-Negative and H. pylori-Positive Cases

et al. 2008

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We histopathologically re-evaluated the histogenesis of gastric carcinomas from comparative studies between Helicobacter pylori-positive and H. pylori-negative cases using the gastritis score from the Updated Sydney System. The incidence of H. pylori-negative gastric carcinomas was 3.11% (12/386); they are likely to develop in the fundic gland mucosa, and show a gastric phenotype by mucin immunohistochemistry. Even in cases of completely gastric and predominantly gastric phenotypes, CDX2 protein was expressed in most cases (90.9% of pT1 and 100% of pT2-3), indicating a possibility that intestinalization of carcinoma cells occurs independently of the background mucosa. Regarding the degree of gastritis of background mucosa surrounding 143 H. pylori-positive differentiated-type adenocarcinomas, the mean score ranged from 1.497 to 1.713. Our data support the hypothesis that intestinal metaplasia is not a precancerous but a paracancerous lesion, and most gastric adenocarcinomas develop in mildly to moderately atrophic mucosa with H. pylori-infection, i.e., ongoing atrophy.

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Intramucosal gastric adenocarcinoma of poorly differentiated type in the young is characterized by Helicobacter pylori infection and antral lymphoid hyperplasia

Cited by 29 publications

References 24 publications

Gastric Cancer in the Young: Is It a Different Clinical Entity? A Retrospective Cohort Study

Gastric Cancer in the Young: Is It a Different Clinical Entity? A Retrospective Cohort Study

Induced nitric oxide synthetase and peroxiredoxin expression in intramucosal poorly differentiated gastric cancer of young patients

Re-evaluation of Histogenesis of Gastric Carcinomas: A Comparative Histopathological Study Between Helicobacter pylori-Negative and H. pylori-Positive Cases

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