Characterization of Helicobacter pylori-Naïve Early Gastric Cancers

Yamada, Akihiro; Kaise, Mitsuru; Inoshita, Naoko; Toba, Takahito; Nomura, Kosuke; Kuribayashi, Yasutaka; Yamashita, Satoshi; Furuhata, Tsukasa; Kikuchi, Daisuke; Matsui, Akira; Mitani, Toshifumi; Ogawa, Osamu; Iizuka, Toshiro; Hoteya, Shu

doi:10.1159/000487795

Cited by 43 publications

(56 citation statements)

References 21 publications

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“…The foveolar epithelial type is considered to develop from surface mucous cells, of which MUC5AC is a marker. This type of gastric cancer has been reported previously; the tumor was reported to spread laterally and with some degree of elevation, with villous or papillary surface, as we observed in the present study [26]. Unlike the undifferentiated type or the fundic gland type, the Dig Dis 2020;38:474-483 DOI: 10.1159/000506120 field of cancerization is superficial.…”

Section: Discussionsupporting

confidence: 84%

“…Demarcation lines could be well recognized in lesions invading the submucosa, as tumor cells were not covered by normal mucosa, whereas in lesions invading the mucosa, it was difficult to detect demarcation lines because the tumor cells were not exposed. All lesions were of the undiffer- [24][25][26], 3 lesions (60%) in this study were observed to have invaded the submucosa. The IHC pattern did not show any regularity; some lesions were not only negative for MUC2 or CD10 but also for MUC6.…”

Section: Undifferentiated Typementioning

confidence: 45%

“…Several case reports, which have recently appeared, present the varying endoscopic appearance and pathological characteristics of HPINGC [19][20][21][22][23][24]. For instance, intraepithelial signet ring cell carcinoma is reported as one of the typical HPINGCs [24][25][26]. Ueyama et al [27] has proposed "gastric adenocarcinoma of the fundic gland type (chief cell-predominant type)," which does not present with the typical epithelial occurrence of inflammation and atrophy caused by HP infection.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic and Pathological Characteristics of Helicobacter pylori Infection-Negative Early Gastric Cancer

Mizutani

Araki

Saigo

et al. 2020

Dig Dis

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Background: The characteristics of Helicobacter pylori (HP) infection-negative gastric cancer (HPINGC) have not been well documented because of the rareness. The aim of this study was to classify HPINGC endoscopically and clinicopathologically. Methods: This retrospective study included 1,741 early gastric cancer lesions and evaluated their HP infection status. Expression levels of MUC5AC, MUC6, MUC2, CD10, p53, MIB-1, pepsinogen-I, H+/K+ ATPase, chromogranin A, E-cadherin, and gastrin were evaluated in tumors by immunohistochemistry (IHC). Results: Among the analyzed lesions, 19 (1.1%) were diagnosed as HPINGC and classified into 6 types: undifferentiated (5 lesions), fundic gland (2 lesions), cardiac gland (1 lesion), pyloric gland (3 lesions), foveolar (5 lesions), and mixed (3 lesions) types. Undifferentiated lesions were of pale color, with unclear demarcation and decreased E-cadherin expression. Fundic-type lesions were tan to reddish in color, with submucosal tumor-like protrusions, and positive for pepsinogen-I and H+/K+ ATPase. The cardiac gland type was located in the gastroesophageal junction and was positive for MUC6 and pepsinogen-I. Pyloric gland-type lesions were of the same color as normal mucosa, with mild elevation and unclear demarcation, likely positive for CD10 and chromogranin A. Foveolar epithelial-type lesions were white and elevated, with defined demarcation, and contained MUC5AC-positive cells. Mixed-type lesions, showing various staining patterns in IHC, had both elevated and depressed shape and reddish color. Conclusion: Endoscopic observation and IHC were useful for classifying the characteristics of HPINGC, which may preserve the characteristics of its region of origin.

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Section: Discussionsupporting

confidence: 84%

Section: Undifferentiated Typementioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

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Endoscopic and Pathological Characteristics of Helicobacter pylori Infection-Negative Early Gastric Cancer

Mizutani

Araki

Saigo

et al. 2020

Dig Dis

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“…Signet ring cell carcinoma is well known as a typical histology of undifferentiated‐type HpUGC . In general, compared with PDA, SRCC progresses more slowly without massive invasion .…”

Section: Discussionsupporting

confidence: 61%

Potential of Helicobacter pylori‐uninfected signet ring cell carcinoma to invade the submucosal layer

Yorita

Ito

Boda

et al. 2019

J of Gastro and Hepatol

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Background and Aim:The typical histology of Helicobacter pylori-uninfected gastric cancer is signet ring cell carcinoma (SRCC) localized in the mucosal layer, but the potential of these SRCCs to invade the submucosal layer is unclear. This study aimed to investigate the clinicopathological characteristics of SRCC in H. pylori-uninfected patient and its prevalence in diffuse-type gastric cancer (DGC) within Japan. Methods: We enrolled consecutive pure DGC patients diagnosed with the disease either localized in the mucosal layer or with submucosal invasion. H. pylori infection was investigated, and the patients were divided into three groups according to histological types: pure SRCC, SRCC with poorly differentiated adenocarcinoma (PDA), and pure PDA. Results: Of the 345 pure DGC patients, 132 (38%), 127 (37%), and 86 (25%) had pure SRCC, SRCC with PDA, and pure PDA histologies, respectively. The prevalence of H. pylori infection and the SM ratio were significantly lower in the pure SRCC group than other groups (P < 0.01). Twenty-two (6.4%) patients, including two with submucosal invasion, were negative for H. pylori and had mucosal SRCC component in the cancer lesions. Of the 259 SRCC cases (pure SRCC or SRCC + PDA), H. pylori-uninfected cases had different clinicopathological characteristics compared with H. pylori-positive cases. Particularly, the ratio of patients with submucosal invasive SRCC was significantly lower in the H. pylori-uninfected gastric cancer group than in those with H. pylori infection. Conclusion: Helicobacter pylori-uninfected gastric cancer is not rare among pure DGC patients in Japan. SRCC in patients without H. pylori infection is less likely to be invasive.

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“…In Japan, the majority of patients with GC are Hp -positive, Hp -eradication, and Hp -uninfected GC accounts for <1% [3, 4]. However, as eradication therapy of Hp has been performed widely, the proportion of Hp -positive patients has gradually decreased, and Hp -uninfected GC is expected to increase relatively [5].…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological and Endoscopic Features of Raspberry-Shaped Gastric Cancer in Helicobacter pylori-Uninfected Patients

et al. 2020

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Background: Gastric adenocarcinoma of foveolar type (GA-FV) is a raspberry-shaped gastric cancer (RSGC) and garners much attention as H. pylori (Hp)-uninfected gastric cancer. However, the classification and clinicopathological and endoscopic features of RSGCs in Hp-uninfected patients are poorly defined. We designed a new histopathological classification of RSGC and compared them via endoscopic and clinicopathological characteristics. Summary: From 996 patients with early gastric cancers resected by endoscopy in our hospital, we studied 24 RSGC lesions from 21 (2.4%) Hp-uninfected patients. RSGCs were classified into 3 histological types as follows: GA-FV (n = 19), gastric adenocarcinoma of fundic gland type (GA-FG, n = 2), and gastric adenocarcinoma of fundic gland mucosa type (GA-FGM, n = 3). Most of the lesions were found at the greater curvature of the upper or middle third of the stomach. GA-FV lesions were homogeneously reddish and frequently accompanied with a whitish area around the tumor and an irregular microvascular (MV) pattern; these features were confirmed histopathologically by the presence of homogeneous neoplastic foveolar epithelium with foveolar hyperplasia around the tumors. GA-FG lesions might be heterogeneously reddish with a submucosal tumor shape and regular MV pattern; these were confirmed by the presence of covered or mixed nonneoplastic epithelium on deeper regions of tumors. GA-FGM lesions might be homogeneously reddish and occasionally had a submucosal tumor shape and irregular MV pattern; these were confirmed by the presence of homogeneous neoplastic foveolar epithelium on deeper regions of the tumors. Key Messages: RSGCs in Hp-uninfected patients are classified into 3 histopathological types. For accurate diagnosis of RSGCs, it may be necessary to fully understand endoscopic features of these lesions based on these histological characteristics and to take a precise biopsy.

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Characterization of Helicobacter pylori-Naïve Early Gastric Cancers

Cited by 43 publications

References 21 publications

Endoscopic and Pathological Characteristics of <b><i>Helicobacter pylori</i></b> Infection-Negative Early Gastric Cancer

Endoscopic and Pathological Characteristics of <b><i>Helicobacter pylori</i></b> Infection-Negative Early Gastric Cancer

Potential of Helicobacter pylori‐uninfected signet ring cell carcinoma to invade the submucosal layer

Clinicopathological and Endoscopic Features of Raspberry-Shaped Gastric Cancer in Helicobacter pylori-Uninfected Patients

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