Does eradication of Helicobacter pylori reduce the risk of carcinogenesis in the residual stomach after gastrectomy for early gastric cancer? Comparison of mucosal lesions in the residual stomach before and after Helicobacter pylori eradication.
OBJECTIVE
After partial gastrectomy, the mucosa of the residual stomach usually undergoes severe changes, and these lesions are known to be pre-cancerous. Recently, Helicobacter pylori has been highlighted as an agent that induces such mucosal alterations. In the present study, we evaluated whether eradication of H. pylori reduced the risk of carcinogenesis.


METHODS
The subjects were 12 patients who underwent distal gastrectomy with Billroth I anastomosis for early gastric cancer and were positive for H. pylori. We performed endoscopy and biopsy both before and after H. pylori eradication therapy to assess changes in the gastric mucosa.


RESULTS
After eradication therapy, no mucosal edema or erythema was detected. On histological examination, mononuclear cell infiltration had decreased and there was complete absence of neutrophil infiltration. The Ki-67 labeling index and the tissue IL-8 level had also decreased significantly, compared with before eradication.


CONCLUSIONS
Before H. pylori eradication, the mucosa of the residual stomach may be at high risk of carcinogenesis due to induction of mucosal damage and active gastritis by H. pylori. Such changes were almost completely normalized by eradication therapy, so the eradication of H. pylori may reduce the risk of H. pylori-associated carcinogenesis in patients who have undergone gastrectomy for early gastric cancer.
Hamaguchi
K
K
Department of Surgery, Tokyo Women's Medical University, Daini Hospital, 2-1-10 Nishiogu, Arakawa-ku, 116-8567 Tokyo, Japan.
Ogawa
K
K
Katsube
T
T
Konno
S
S
Aiba
M
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic; D017291:Clarithromycin / Q000627:therapeutic use; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005753:Gastric Mucosa / Q000473:pathology; D005763:Gastroenterostomy / Q000009:adverse effects; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000382:microbiology* / Q000517:prevention & control; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D064747:Lansoprazole; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole