Endoscopic and histological features of gastric cancers after successful Helicobacter pylori eradication therapy
Endoscopic and histological features of gastric cancers after successful Helicobacter pylori eradication therapy
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DOI：
10.1007/s10120-015-0479-y
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发表时间：
2016-04-01
期刊：
影响因子：
7.4
通讯作者：
Nimura, Satoshi
中科院分区：
文献类型：
--
作者：
Saka, Akiko;Yagi, Kazuyoshi;Nimura, Satoshi
幽门螺杆菌根除治疗后的胃癌常因其边界不清或缺乏明显的癌性特征而难以内镜诊断。此外，已变得明显的是，非肿瘤上皮细胞在根除后覆盖胃癌中的癌区域。在此，我们研究了这些内镜特征及其与组织学结果的关系，我们研究了24例和47例胃癌患者，这些患者接受了（根除组）和未接受（对照组）H。pylori根除。传统内镜检查显示的胃炎样外观定义为与周围非癌区域无显著差异的粘膜模式，窄带成像（NBI）放大内镜检查（ME）显示的粘膜模式定义为H。幽门相关性萎缩性胃炎我们研究了传统内镜检查显示的胃炎样外观（A），NBI-ME显示的癌区边缘（B）和癌区内（C）的胃炎样外观，以及覆盖的非肿瘤上皮的组织学特征。我们还评估了根除组内镜检查结果与组织学检查结果之间的关系，内镜检查显示根除组中A、B和C特征明显更常见（分别为P = 0.031，P <0.001，P < 0.001）。非肿瘤上皮覆盖超过10%的癌区域在根除组中更常见。在根除组中，超过90%的表现出胃炎样外观的癌症具有延伸超过10%的癌区域的非肿瘤上皮。由于覆盖癌组织的非肿瘤上皮，幽门根除往往具有胃炎样特征。
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.We studied 24 and 47 gastric cancers in patients who had (eradication group) and had not (control group) undergone H. pylori eradication, respectively. A gastritis-like 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.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). Non-neoplastic 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.Gastric cancer after successful H. pylori eradication tends to have gastritis-like features due to non-neoplastic epithelium covering the cancerous tissue.