Early-Stage Gastric Cancer Can Be Found in Improved Atrophic Mucosa over Time from Successful Helicobacter pylori Eradication

Digestion. 2017;95(3):194-200. doi: 10.1159/000460245. Epub 2017 Mar 14.

Abstract

Background/aims: Early-stage gastric cancer (EGC) is detected even after successful Helicobacter pylori eradication. This study is aimed at clarifying the clinicopathological characteristics of EGC detected after successful H. pylori eradication.

Methods: This retrospective study analyzed 57 cases of EGC detected after successful H. pylori eradication and resected endoscopically at Kyoto Prefectural University of Medicine, between January 2009 and June 2014. Clinicopathological findings of 57 cases (H. pylori-eradicated group) were investigated, and compared with those in active H. pylori infection resected in the same period (H. pylori-positive group).

Results: Most EGCs were detected in patients with severe atrophic mucosa, both in H. pylori-eradicated and H. pylori-positive groups, while the percentage of EGC detected in patients with mild atrophic mucosa gradually increased over time from successful eradication (H. pylori-positive: 7%, up to the fourth year since eradication: 11%, after the fifth year since eradication: 32%). The percentage of EGC detected in patients with mild atrophic mucosa after the fifth year since eradication was significantly higher than that in patients with active H. pylori infection (p = 0.004).

Conclusion: After the fifth year following eradication, we should be alert to the incidence of EGC, irrespective of the severity of mucosal atrophic change.

Keywords: Detection; Early-stage gastric cancer; Eradication; Helicobacter pylori; Mucosal atrophy.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Endoscopic Mucosal Resection
  • Female
  • Gastric Mucosa / microbiology
  • Gastric Mucosa / pathology*
  • Gastric Mucosa / surgery
  • Gastroscopy
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / drug effects
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Incidence
  • Japan
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery

Substances

  • Anti-Bacterial Agents