Characteristics of non-neoplastic epithelium that appears within gastric cancer with and without Helicobacter pylori eradication: A retrospective study

Abstract

A non-neoplastic epithelium (NE) often appears in gastric cancer (GC). We explored the histological features of NE in comparison between HP-eradicated and HP-infected GCs. We enrolled 40 HP-eradicated and 40 HP-infected GCs matched by size, macroscopic and histological type. NE was classified into full gland type and surface type; the former was a non-neoplastic gland isolated within cancer, and the latter was NE on the surface of the cancer. Surface type was additionally divided into NE at the cancer margin (marginal surface type) and NE inside cancer (internal surface type). The primary endpoints were the frequency and the length ratio (the ratio to cancer length) of NE. The secondary endpoints were the relationships between NE and clinicopathological factors, including endoscopic findings of a gastritis-like appearance (GLA), reddish depressed lesion (RDL), and white nodular mucosa (WNM). The frequency and length ratio of the internal surface type in HP-eradicated GCs were significantly higher (82.5% vs 50%, P = 0.005) and larger (11.6 ± 10.6 vs 4.2 ± 9.9, P < 0.001) than those in HP-infected GCs, and the increase was more significant according to the passage of time since HP eradication. The frequency and length ratio of marginal surface type and full gland type were not significantly different between the two groups, but the coexistence of internal surface and full gland types was statistically significant (p < 0.001). The frequencies of GLA, RDLs, and WNM in HP-eradicated GCs were significantly higher than those in HP-infected GCs. GLA-positive GCs were covered more widely by internal surface type than GLA-negative GCs (13.3% vs. 6.6%, P = 0.003). Various types of NE were noted in gastric cancer, and the internal surface type of NE was shown to be significantly linked to HP-eradicated cancer and GLA.

Characteristics and background mucosa status of early gastric cancer after Helicobacter pylori eradication: A narrative review

“…Next, according to the location and structure, NE was classified into full gland, marginal surface and internal surface types. Noda et al [33] found that only internal surface type was significantly linked to H pylori -eradicated cancer.…”

“…[64] The findings demonstrate that NBI-ME has significantly superior diagnostic accuracy to WLE for gastric cancer after H pylori eradication, especially for lesions with a “gastritis-like” appearance. [33,65] Furthermore, blue laser imaging (BLI) is a new image-enhanced endoscopy technique that uses laser illumination to change brightness and contrast. [66,67] BLI has improved diagnostic performance for lesions compared with NBI in brightness and contrast.…”

Pharmacological and molecular analysis of the effects of Huangqi Jianzhong decoction on proliferation and apoptosis in GES-1 cells infected with H. pylori

“…About 60% of gastric cancer patients from developed countries, and 75% of patients with gastric cancer from developing countries suffer from chronic H. pylori infection ( Park et al, 2021 ). Chronic gastritis caused by H. pylori infection results in the release of pathogenic factors such as urease, vacuolar toxin A, CagA protein, inflammatory mediators, and reactive oxygen species metabolites, which lead to abnormal proliferation and apoptosis of gastric mucosal epithelial cells, resulting in gastric cancer ( Noda et al, 2021 ). Although recent progress with antibiotics and other drugs has been made in treating H. pylori infection, it remains an important factor in increasing the incidence of gastric cancer ( Ding, 2020 ).…”