Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial

Fukase, Kazutoshi; Kato, Mototsugu; Kikuchi, Shogo; Inoue, Kentaro; Uemura, Naomi; Okamoto, Shigefumi; Terao, Shuichi; Amagai, Kenji; Hayashi, Shunji; Asaka, Masahiro

doi:10.1016/s0140-6736(08)61159-9

Cited by 1,119 publications

(963 citation statements)

References 43 publications

(38 reference statements)

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“…Ten of 14 patients were male and the mean age at the occurrence of gastric cancer after eradication was 71 (9) years. The indications for eradication therapy were endoscopic mucosal resection for early gastric cancer in 10 cases (Fukase et al 2008), gastric ulcer in 2 cases, duodenal ulcers in 1, and idiopathic thrombocytopenic purpura in 1 case (Kohda et al 2002), and the mean period from the eradication to the subsequent occurrence of gastric cancer was 74 (44) months. In 10 patients who had received endoscopic mucosal resection previously, since none of the new cancerous lesions emerged from the preceding resection scar, they were unlikely to have been residual cancer due to incomplete endoscopic procedure.…”

Section: Resultsmentioning

confidence: 99%

“…Recent studies consistently reported that H. pylori eradication had some inhibitory effects on the subsequent development of gastric cancer, at least in certain conditions (Take et al 2005;Takenaka et al 2007;Fukase et al 2008;Ogura et al 2008). However, it also has been revealed that there are sporadic cases of gastric cancer even after successful eradication (Kamada et al 2005;Yanaoka et al 2009;de Vries et al 2009).…”

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confidence: 99%

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Gastric Cancers Emerging after H. pylori Eradication Arise Exclusively from Non-Acid-Secreting Areas

Iijima

Abe

Koike

et al. 2012

Tohoku J. Exp. Med.

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Although Helicobacter pylori (H. pylori) eradication has some inhibitory effects on the subsequent development of gastric cancer, there are sporadic cases of gastric cancer even after successful eradication. The pathogenesis of gastric cancer emerging after H. pylori eradication remains to be clarified. In this study, employing Congo-red chromoendoscopy, which is capable of visualizing the acid-secreting fundic mucosa, we investigated the topographic relationship of the acid secretion pattern to the occurrence site of gastric cancers emerging after eradication. Fourteen consecutive patients who suffered from new gastric cancer after eradication, defined as lesions that were discovered at least 2 years after the eradication, were prospectively enrolled. Whether the neoplasias arose from acid-secreting or nonacid-secreting areas was evaluated with Congo-red chromoendoscopy. Biopsy specimens taken from the two areas were subjected to histologic evaluation and immunohistochemistry for Ki-67 and p53. The mean period from the eradication to the subsequent occurrence of gastric cancer was 74 (44) months. There were two cancer lesions in 5 cases, and thus there was a total 19 lesions from 14 cases. Congo-red chromoendoscopy revealed that all 19 lesions arose exclusively from non-acid-secreting areas. Histological examination revealed sustained hyperproliferation and accumulation of p53 protein was frequently detectable in non-acid-secreting areas. Genetic alteration such as p53 mutation seems to be already present in the residual non-acid-secreting areas after eradication, areas that could be the origin of gastric carcinogenesis after eradication. Identification of such high-risk areas should be a promising approach for estimating the individual cancer risk after eradication.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Gastric Cancers Emerging after H. pylori Eradication Arise Exclusively from Non-Acid-Secreting Areas

Iijima

Abe

Koike

et al. 2012

Tohoku J. Exp. Med.

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“…In gastric cancer in which Helicobacter pylori (H. pylori) infection-associated, aberrant methylation is shown to be implicated [10], eradication of H. pylori has been shown to reduce the risk of developing gastric cancer not only in animal studies, but also in a prospective, multicenter, randomized, controlled trial [11].…”

Section: Discussionmentioning

confidence: 99%

Human intestinal spirochetosis is significantly associated with sessile serrated adenomas/polyps

Omori

Mabe

Hatanaka

et al. 2014

Pathology - Research and Practice

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Aims: It remains unclear whether or not human intestinal spirochetosis (HIS) has any associated symptoms or lesions. In this study, we assessed the prevalence of HIS in sessile serrated adenomas/polyps (SSA/Ps) and their possible association.Methods: Following identification of early cecal cancer with SSA/P accompanied by a colonization of HIS, we went on to conduct a retrospective, case-control study, using endoscopically resected SSA/P specimens to examine the frequency of HIS infection in SSA/Ps.Results: Nineteen SSA/P cases and 172 controls were obtained. The rate of HIS infection was significantly higher at 52.6% (10/19) in the SSA/P cases compared to the controls at 8.1% (14/172). Conclusions:Our SSA/P series were associated with a remarkably higher rate of HIS than controls or than previously reported. This is the first report to provide evidence for potential association between HIS and SSA/Ps.

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“…Even though the further advanced the existing preneoplastic condition is, the less likely it is that H pylori eradication will stop gastric cancer development (37,59) , a randomized study of patients undergoing H pylori eradication following early gastric cancer resection was able to demonstrate a reduction in the appearance of metachronous gastric cancer (66) .…”

Section: Randomized Controlled Trials Conducted In Colombia Andmentioning

confidence: 99%

“…Metachronous tumors in the gastric remnant have been described in up to 10% of patients undergoing gastric, endoscopic or surgical resection for early gastric cancer (182,187,194) . A recent randomized controlled trial from Japan showed that eradication of H pylori in patients undergoing endoscopic resection for early gastric cancer, followed for 3 years, was able to reduce the risk of developing metachronous gastric cancer from 4 per 100 persons per year to 1.4 per 100 persons per year in the eradicated group (66) . Also considered high-risk patients for development of gastric cancer are those undergoing gastric resections for benign diseases (peptic ulcer, for example) and patients carrying other gastric neoplasias such as adenoma and MALT lymphoma.…”

Section: Statement 19mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial

Abstract: Background

Cited by 1,119 publications

References 43 publications

Gastric Cancers Emerging after H. pylori Eradication Arise Exclusively from Non-Acid-Secreting Areas

Gastric Cancers Emerging after H. pylori Eradication Arise Exclusively from Non-Acid-Secreting Areas

Human intestinal spirochetosis is significantly associated with sessile serrated adenomas/polyps

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

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