Ten-year prospective follow-up of histological changes at five points on the gastric mucosa as recommended by the updated Sydney system after Helicobacter pylori eradication

Kodama, Masaaki; Murakami, Kazunari; Okimoto, Tadayoshi; Sato, Ryugo; Uchida, Masahiro; Abe, Takashi; Shiota, Seiji; Nakagawa, Yoshifumi; Mizukami, Kazuhiro; Fujioka, Toshio

doi:10.1007/s00535-011-0504-9

Cited by 117 publications

(107 citation statements)

References 38 publications

(50 reference statements)

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“…There have been some reports of metachronous gastric cancer development after the eradication of H. pylori [11,12,13]. In addition, some studies have investigated changes in the health of the gastric mucosa, such as the severities of atrophic gastritis and intestinal metaplasia, after H. pylori eradication [14,15,16,17]. Given these situations, it is highly required to predict the risk of cancer development in the era of H. pylori eradication and development of the better predictive biomarkers for gastric cancer is necessary.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Kitamura¹,

Muguruma²,

Okamoto³

et al. 2017

Digestion

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Background/Aims: Gastric xanthomas are frequently observed in the stomach as small yellowish plaques or nodules. A close relationship among Helicobacter pylori infection, atrophic gastritis, and xanthomas has been reported. We assessed the clinicopathological features of gastric cancer with or without xanthomas. Methods: A total of 91 patients who were diagnosed as having early gastric cancer were enrolled. We evaluated the gastritis status using scores for gastritis and atrophy, positivity of H. pylori infection, the prevalence rate of xanthomas, and the clinicopathological features of gastric cancer. Results: Gastric xanthomas were observed in 72.5% of early gastric cancer cases. Scores for gastritis and atrophy were significantly higher in the xanthoma-positive group than those in the xanthoma-negative group. A higher prevalence of differentiated-type adenocarcinoma was found in the xanthoma-positive group. Among the cases with multiple gastric xanthomas, the prevalence of males was significantly higher than that of females. Conclusion: A high prevalence rate of gastric xanthomas in gastric cancer cases was shown. Xanthomas were highly associated with age, the severities of gastritis and atrophy, and differentiated-type adenocarcinoma. Regardless of the eradication of H. pylori, xanthomas may be useful predictive markers for the development of differentiated-type adenocarcinoma.

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Section: Introductionmentioning

confidence: 99%

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Kitamura¹,

Muguruma²,

Okamoto³

et al. 2017

Digestion

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“…Nevertheless, our study indicates that the degree of gastric mucosal atrophy “at the time of follow-up examination” is not necessarily a risk factor for developing gastric cancer, especially in cases where several years have passed after eradication, which is a new evidence. In some cases, gastric mucosal atrophy improved partly after successful eradication [20], which may be responsible, in our opinion, for the high EGC detection rate experienced with mild atrophic mucosa in the LD subgroup observed in our study. Hence, extraordinary care must be taken during follow-up endoscopic examinations, especially long after H. pylori eradication, to check for the incidence of EGC, irrespective of the severity of atrophic change.…”

Section: Discussionmentioning

confidence: 77%

Early-Stage Gastric Cancer Can Be Found in Improved Atrophic Mucosa over Time from Successful <b><i>Helicobacter pylori</i></b> Eradication

et al. 2017

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Background/Aims: Early-stage gastric cancer (EGC) is detected even after successful Helicobacter pylori eradication. This study is aimed at clarifying the clinicopathological characteristics of EGC detected after successful H. pylori eradication. Methods: This retrospective study analyzed 57 cases of EGC detected after successful H. pylori eradication and resected endoscopically at Kyoto Prefectural University of Medicine, between January 2009 and June 2014. Clinicopathological findings of 57 cases (H. pylori-eradicated group) were investigated, and compared with those in active H. pylori infection resected in the same period (H. pylori-positive group). Results: Most EGCs were detected in patients with severe atrophic mucosa, both in H. pylori-eradicated and H. pylori-positive groups, while the percentage of EGC detected in patients with mild atrophic mucosa gradually increased over time from successful eradication (H. pylori-positive: 7%, up to the fourth year since eradication: 11%, after the fifth year since eradication: 32%). The percentage of EGC detected in patients with mild atrophic mucosa after the fifth year since eradication was significantly higher than that in patients with active H. pylori infection (p = 0.004). Conclusion: After the fifth year following eradication, we should be alert to the incidence of EGC, irrespective of the severity of mucosal atrophic change.

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“…Many studies have reported that H. pylori eradication improves gastric atrophy and intestinal metaplasia, which can be regarded as a precancerous lesion [27-29]. Thus, H. pylori eradication may prevent GC [6-11].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and Immunohistochemical Characteristics of Gastric Cancer with versus without Helicobacter Pylori Eradication

Kodama¹,

Mizukami

Abe³

et al. 2018

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Background/Aims: The rate of gastric cancer (GC) after Helicobacter pylori eradication has gradually increased; therefore, we investigate the clinicopathological features of GC following eradication in comparison with those of GC with H. pylori infection. Methods: This study included 50 subjects with GC after eradication (GCE) and 151 patients with GC with H. pylori infection (GCI). Clinicopathological factors were assessed. The manifestation of GC was further evaluated using immunohistochemical analysis and in situ hybridization. Results: Macroscopic analysis revealed a significantly higher ratio of depressed type /elevated type in the GCE compared with the GCI (30/19 vs. 61/77, p = 0.041). The gastric phenotype was more common in the GCE compared with the GCI, and the proportion of CDX2-positive cases was lower in the GCE (8 out of 18; 44.4%) compared with the GCI (18 out of 19; 94.7%; p = 0.00082). Ki-67 labeling index was significantly lower in the GCE (32.03 ± 22.15) compared with the GCI (79.20 ± 14.87, p < 0.0001). No patient in the GCE showed evidence of Epstein-Barr virus infection. Conclusion: The clinicopathological characteristics of GC following H. pylori eradication differ from those of GC in patients with H. pylori infection in terms of morphology, mucin phenotype, and proliferation rate.

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Ten-year prospective follow-up of histological changes at five points on the gastric mucosa as recommended by the updated Sydney system after Helicobacter pylori eradication

Abstract: In 10 years after H. pylori eradication, atrophy at all sites and IM in the lesser curvature of the corpus gradually and significantly decreased. These results suggest that the improvement of gastric atrophy and IM might have association with the reduction of gastric cancer occurrence.

Cited by 117 publications

References 38 publications

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Clinicopathological Assessment of Gastric Xanthoma as Potential Predictive Marker of Gastric Cancer

Early-Stage Gastric Cancer Can Be Found in Improved Atrophic Mucosa over Time from Successful <b><i>Helicobacter pylori</i></b> Eradication

Endoscopic and Immunohistochemical Characteristics of Gastric Cancer with versus without Helicobacter Pylori Eradication

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