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Background and aim: Gastric carcinogenesis involves CpG island hypermethylation (CIHM) of tumor-suppressor genes. Although the CIHM of these genes occurs in non-neoplastic gastric cells, it is unclear whether this epigenetic alteration is linked with aging and/or gastric cancer risk. We investigated this linkage in noncancerous gastric mucosa infected with H. pylori . Subjects and methods: Noncancerous corpus mucosa was endoscopically obtained from H. pylori -positive gastric cancer patients (n = 34), and age-matched H. pyloripositive noncancerous controls (n = 68). Genomic DNA retrieved from the mucosa was subjected to methylation-specific polymerase chain reaction for p16 , Ecad , and DAPK genes. Linkage between CIHM and clinicopathologic factors was evaluated. Results: CIHM rates of DAPK , Ecad , and p16 promoters were significantly higher in noncancerous gastric mucosa of gastric cancer patients (91, 88, and 68%, respectively) than in noncancerous controls (71, 53, and 25%, respectively). Multivariate regression analysis showed a significant linkage between CIHM in noncancerous mucosa and coexistence of gastric cancer. Significant linkage between polymorphoneutrophil infiltration and CIHM was observed except for CIHM of p16 . No linkage was observed between CIHM and other parameters, including age. High CIHM status (all three tested genes methylated) was associated with an increased risk of gastric cancer, with an odds ratio of 9.8 (95% confidence interval, 3.8-25.3). Conclusions: In a subset of the H. pylori -infected population, CIHM of tumorsuppressor genes in noncancerous gastric mucosa is linked with the risk of gastric cancer and polymorphoneutrophil infiltration, but not aging. CIHM is a potential marker of gastric cancer risk.

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An inflammatory myoglandular polyp of the large bowel is a rare but distinct clinical entity that was first described by Dr S Nakamura and others in 1992. It is characterized histologically by inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle and hyperplastic glands which sometimes show cystic dilatation. The typical endoscopic appearance is that of a pedunculated spherical polyp with a smooth surface and patchy redness that resembles a ripe strawberry. There may also be a patchy mucous exudate. Thus far, only a small number of cases have been reported and the pathogenesis and natural history remain unclear. We describe the endoscopic and histological findings of an inflammatory myoglandular polyp in the distal transverse colon.A 42-year-old Japanese man was investigated because of a positive fecal occult blood test. Barium enema radiographs revealed two colonic polyps: one in the distal transverse colon and one in the sigmoid colon. At colonoscopy, the polyp in the transverse colon was approximately 10 mm in diameter with a spherical shape, pedunculated base and a smooth surface as shown in Figure 1. Red areas were noted on the surface of the polyp. Histological evaluation revealed hyperplastic glands and an inflamed and widened fibromuscular stroma with lymphoid follicles ( Fig. 2; HE ×25). The appearance was consistent with an inflammatory myoglandular polyp. The polyp in the sigmoid colon was a small tubular adenoma. Inflammatory myoglandular polyps need to be distinguished from Peutz-Jegher-type polyps, juvenile polyps, inflammatory polyps, inflammatory cap polyps, and polyps associated with mucosal prolapse, sometimes involving colostomy sites.

Background and Aim Ulcerative colitis (UC) is usually detected by clinical symptoms, such as bleeding and diarrhea; however, it is rather difficult to assess during asymptomatic clinical remission (CR). Hence, there is a need for a biomarker that can reliably detect UC during remission. We previously reported on the utility of the prostaglandin E‐major urinary metabolite (PGE‐MUM) as a biomarker reflecting UC activity. In this study, we evaluated the effectiveness of the PGE‐MUM in the diagnosis of endoscopic, histological, and histo‐endoscopic mucosal remission of UC, comparing with fecal tests. Methods This prospective study was conducted at the Jikei University Hospital between August 2017 and January 2021. Patients with UC in CR scheduled to undergo colonoscopy were included. The association between the PGE‐MUM with endoscopic remission (ER), histological remission (HR), and complete mucosal healing (CMH, defined as histo‐endoscopic remission) was analyzed. We also compared the area under the curve (AUC) for the receiver operating characteristic curves between PGE‐MUM, fecal calprotectin (FC), and fecal immunochemical test (FIT). Results In total, 128 patients were analyzed. PGE‐MUM differed significantly in ER versus non‐ER (14.5 vs 16.7, P = 0.028), HR versus non‐HR (14.2 vs 17.4, P = 0.004), and CMH versus non‐CMH (14.3 vs 16.7, P = 0.021). There were no significant differences between the AUCs for PGE‐MUM, FC, and FIT for ER, HR, or CMH. Conclusions The PGE‐MUM can determine CMH in UC even during CR, regardless of the disease phenotype, indicating its clinical benefit for non‐invasive monitoring.