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

Kitamura, Shinji; Muguruma, Naoki; Okamoto, Koichi; Tanahashi, Takao; Fukuya, Akira; Tanaka, Kumiko; Fujimoto, Daisaku; Kimura, Tooru; Miyamoto, Hiroshi; Bando, Yoshimi; Takeuchi, Hisashi; Shiba, Masako; Takayama, Tetsuji

doi:10.1159/000481346

Cited by 23 publications

(19 citation statements)

References 32 publications

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“…Body findings, such as body xanthoma and RHG probably denoted hypoacidity derived from active inflammation, similar to the report previously published [ 20 , 21 ]. Body diffuse erythema means interstitial inflammatory cell infiltration in the atrophy background [ 11 , 22 ].…”

Section: Discussionsupporting

confidence: 90%

Assessment of Gastric Acidity by Conventional Endoscopy With Serological Gastric Markers

Kim

Song

Kwon³

et al. 2018

Gastroenterol Res

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BackgroundGastric acidity could determine Helicobacter pylori (H. pylori)-associated gastritis patterns. In reverse, H. pylori infection could lead disturbance in gastric acid secretion. We attempted to elucidate gastric acid status by conventional endoscopy with pepsinogen test.MethodsA total of 196 subjects who visited our health promotion center were consecutively enrolled and evaluated by conventional endoscopy, and blood examinations with pepsinogen I, II, and fasting serum gastrin were conducted. As a Japanese study suggested that in H. pylori-positive subjects the cutoff value was PG I/II ratio ≤ 2.7 for hypochlorhydia, PG I/II ratio ≥ 3.3 for hyperchlorhydria. Based on these serological data, we compared conventional endoscopic images with each acid level.ResultsIt showed that for hypoacidity, older age, and most of the H. pylori-associated endoscopic appearances featuring mucosal inflammation and more atrophy of corpus or antrum were in favor of hypoacidity in closed type. Mucosal appearances showing severe corpus atrophy and remnant gastritis with advanced background atrophy determine hypoacidity in open type. For hyperacidity, mucosal appearances featuring intact mucosa and less severe atrophy were associated with hyperacid status. Male gender, antrum camouflage were also involved in hyperacidity.ConclusionsConventional endoscopy with pepsinogen test could be useful in gastric acid assessment.

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Section: Discussionsupporting

confidence: 90%

Assessment of Gastric Acidity by Conventional Endoscopy With Serological Gastric Markers

Kim

Song

Kwon³

et al. 2018

Gastroenterol Res

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“…GX has received little clinical attention, perhaps because it is considered a benign entity (15). A retrospective cohort study reported that the presence of GX was significantly associated with the presence of GC (13, 14). Another cohort study reported that the presence of GX was a useful marker for predicting the development of GC by performing follow-up EGD (15).…”

Section: Discussionmentioning

confidence: 99%

“…Regarding why GC develops more frequently in patients with GX than in those without GX, the increased release of oxygen free radicals may be involved in the formation of GX (22). Conversely, the presence of GX may reflect the severity and long duration of chronic gastritis (14), a risk factor for the development of GC. In fact, the proportion of patients with atrophy (open type) and the atrophy score of patients were significantly higher in Group C than in Group NC.…”

Section: Discussionmentioning

confidence: 99%

Gastric Xanthoma Is a Predictive Marker for Early Gastric Cancer Detected after <i>Helicobacter pylori</i> Eradication

et al. 2019

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Objective The detection of early gastric cancer (GC) after Helicobacter pylori eradication is expected to increase in Japan. However, the predictive markers for early GC detected after H. pylori eradication have not been extensively studied. We conducted a retrospective, single-center observational study to investigate the predictive markers for early GC detected after H. pylori eradiation. Methods A total of 421 patients underwent endoscopic submucosal dissection for early GC at NTT West Osaka Hospital between June 2006 and August 2017. Data from patients with GC (Group C; n=70) and without GC (Group NC; n=114) after H. pylori eradication were analyzed. Results The proportion of men was significantly higher in Group C than in Group NC (92.9% vs. 65.8%; p<0.0001). Complications with other malignant diseases were more prevalent in Group C than in Group NC. A significantly greater proportion of patients had gastric xanthoma (GX) in Group C than in Group NC (64.3% vs. 14.9%; p<0.0001). Regarding scores for endoscopic findings related to the risk of GC, the atrophy score, intestinal metaplasia score and total score were significantly higher in Group C than in Group NC. A multivariate logistic regression analysis identified male sex, atrophy (open type), the presence of intestinal metaplasia and GX as independent predictors for early GC detected after H. pylori eradication. An atrophy-matched control analysis also identified GX as an independent predictor. Conclusion GX is a novel predictive marker for early GC detected after H. pylori eradication.

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“…4,6 Atrophy-matched control analysis was singled out and the incidence of gastric xanthelasma has been shown to be significantly higher in patients with diabetes mellitus. 3,4,7 The diagnosis should be confirmed in order to eliminate the possibility of gastric malignancy. 8 In our case, xanthoma was diagnosed in an elderly male patient, where erythematous gastropathy was present.…”

Section: Discussionmentioning

confidence: 99%

Gastric xanthelasma: case report

Almeida¹,

Fraga²,

Amaral³

et al. 2020

Int Surg J

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Xanthelasma, also known as Xanthoma or lipid island, is an uncommon gastrointestinal tract (GIT) tumor-like lesion and the stomach is its most frequent location in upper GI lesions, specifically in the gastric antrum, as a single lesion. The pathogenesis appears to be related to healing processes in response to tissue damage provoked by inflammation induced by Helicobacter pylori infection. Many studies have reported that successful H. pylori eradication helps prevent gastric cancer (GC) development. We present a case of a 77 years old patient that showed endoscopic diagnosis of erythematous gastropathy, a gastric antrum xanthelasma and H. Pylori infection. After confirmed H. pylori eradication, the lesion had complete regression. The successful eradication of H. pylori probably led to a total regression of the lesion. Gastric xanthelasma (GX) has been shown to be an independent predictive marker for early GC detection after H. pylori eradication. GX could be a useful marker for predicting the development of gastric cancer.

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

Cited by 23 publications

References 32 publications

Assessment of Gastric Acidity by Conventional Endoscopy With Serological Gastric Markers

Assessment of Gastric Acidity by Conventional Endoscopy With Serological Gastric Markers

Gastric Xanthoma Is a Predictive Marker for Early Gastric Cancer Detected after <i>Helicobacter pylori</i> Eradication

Gastric xanthelasma: case report

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