Characteristic Epithelium with Low‐Grade Atypia Appears on the Surface of Gastric Cancer after Successful <i>Helicobacter pylori</i> Eradication Therapy

Kitamura, Yoko; Ito, Masanori; Matsuo, Taiji; Boda, Tomoyuki; Oka, Shiro; Yoshihara, Masaharu; Tanaka, Shinji; Chayama, Kazuaki

doi:10.1111/hel.12132

Cited by 55 publications

(61 citation statements)

References 21 publications

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“…In our study, several cases in the GCE group also indicated low atypia resembling non-neoplastic epithelium in surface GC cells; moreover, the Ki-67 index was reduced in this area. This finding supports the decrease in inflammation observed in GC following eradication [16, 22, 46]. It is unclear whether these epithelial cells with low atypia were derived from tumor cells or not.…”

Section: Discussionsupporting

confidence: 84%

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

Kodama¹,

Mizukami

Abe³

et al. 2018

Digestion

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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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Section: Discussionsupporting

confidence: 84%

“…It is unclear whether these epithelial cells with low atypia were derived from tumor cells or not. Kitamura et al [16] described that the origin of these cells was not unclear; however, they indicated the possibility that low atypical epithelium may develop from GC cells by the influence of H. pylori eradication.…”

Section: Discussionmentioning

confidence: 99%

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

Kodama¹,

Mizukami

Abe³

et al. 2018

Digestion

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“…As well as histological surface differentiation of cancer [13], surface epithelium with low-grade atypia has also been reported [14]. All of these histological findings were reported to make endoscopic diagnosis difficult, although it remains unresolved whether the latter two types of epithelium are neoplasia or non-neoplasia.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and histological features of gastric cancers after successful Helicobacter pylori eradication therapy

2015

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Background Gastric cancer after successful Helicobacter pylori eradication therapy is often difficult to diagnose by endoscopy because of its indistinct borderline or lack of obviously cancerous characteristics. Furthermore, it has become evident that non-neoplastic epithelium covers cancerous areas in gastric cancer after eradication. Here, we investigated these endoscopic features and their relationship to histological findings. Methods We studied 24 and 47 gastric cancers in patients who had (eradication group) and had not (control group) undergone H. pylori eradication, respectively. A gastritislike appearance revealed by conventional endoscopy was defined as a mucosal pattern with no marked difference from the surrounding non-cancerous area and that revealed by narrow-band imaging (NBI)-magnifying endoscopy (ME) as the mucosal pattern observed in H. pylori-associated atrophic gastritis. We investigated a gastritis-like appearance revealed by conventional endoscopy (A), a gastritis-like appearance at the margin (B) and within (C) the cancerous area revealed by NBI-ME, and the histological characteristics of the overlying non-neoplastic epithelium. We also evaluated the relationship between endoscopic and histological findings in the eradication group. Results Endoscopy showed that features A, B and C were significantly more frequent in the eradication group (P = 0.031, P \ 0.001, P \ 0.001, respectively). Nonneoplastic epithelium covered more than 10 % of the cancerous area more frequently in the eradication group. In the eradication group, more than 90 % of cancers showing a gastritis-like appearance had non-neoplastic epithelium extending over 10 % of the cancerous area. Conclusion Gastric cancer after successful H. pylori eradication tends to have gastritis-like features due to nonneoplastic epithelium covering the cancerous tissue.

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“…2c). In all tumor sections, NE was marked, and its coverage rate on the cancer surface was determined and classified into 4 grades in accordance with a previous study [21]: grade 0, 0% of the tumor length; grade 1, < 5% of the tumor length; grade 2, < 30% of the tumor length; and grade 3, ≥30% of the tumor length. Moreover, the presence or absence of NE at the tumor border, which was assumed to affect the assessment of the DL, was also assessed separately.…”

Section: Methodsmentioning

confidence: 99%

Usefulness of Demarcation of Differentiated-Type Early Gastric Cancers after Helicobacter pylori Eradication by Magnifying Endoscopy with Narrow-Band Imaging

Akazawa¹,

Ueyama²,

Yao³

et al. 2018

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Background/Aims: Early gastric cancer after Helicobacter pylori (Hp) eradication is difficult to demarcate. We used the vessel plus surface classification system (VSCS) to determine whether magnifying endoscopy with narrow-band imaging (ME-NBI) could demarcate differentiated-type early gastric cancers after Hp eradication, and to identify causes of an unclear demarcation line (DL). Methods: Among 100 lesions of differentiated-type early gastric cancer resected endoscopically, 34 lesions in the Hp-eradicated group and 66 in the Hp-infected group were retrospectively compared. Clinicopathological factors and ME-NBI findings, including the presence or absence of the DL, were examined. Histopathologically, histological gastritis, the surface structure at the tumor border, well-differentiated adenocarcinoma with low-grade atypia (tub1-low), and non-neoplastic epithelium (NE) coverage rate on the tumor surface and at the tumor border were evaluated. Results: DL (–) cases were more frequent in the Hp-eradicated group (11.8%, 4/34) than in the Hp-infected group (1.5%, 1/66; p < 0.05). The Hp-eradicated group had a higher NE coverage rate than the Hp-infected group (p < 0.05). All DL (–) cases had tub1-low or NE at the tumor border. Conclusion: ME-NBI with VSCS can identify the DL in most patients (88.2%) with differentiated-type early gastric cancer after Hp eradication.

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Characteristic Epithelium with Low‐Grade Atypia Appears on the Surface of Gastric Cancer after Successful Helicobacter pylori Eradication Therapy

Abstract: Epithelium with low-grade atypia on gastric cancer tissue, which may develop from gastric cancer cells, is frequently present after successful eradication therapy. This phenomenon could influence the practice of endoscopic diagnosis of gastric cancers.

Cited by 55 publications

References 21 publications

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

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

Endoscopic and histological features of gastric cancers after successful Helicobacter pylori eradication therapy

Usefulness of Demarcation of Differentiated-Type Early Gastric Cancers after Helicobacter pylori Eradication by Magnifying Endoscopy with Narrow-Band Imaging

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