Re-evaluation of histogenesis of gastric carcinomas: a comparative histopathological study between Helicobacter pylori-negative and H. pylori-positive cases.
We histopathologically re-evaluated the histogenesis of gastric carcinomas from comparative studies between Helicobacter pylori-positive and H. pylori-negative cases using the gastritis score from the Updated Sydney System. The incidence of H. pylori-negative gastric carcinomas was 3.11% (12/386); they are likely to develop in the fundic gland mucosa, and show a gastric phenotype by mucin immunohistochemistry. Even in cases of completely gastric and predominantly gastric phenotypes, CDX2 protein was expressed in most cases (90.9% of pT1 and 100% of pT2-3), indicating a possibility that intestinalization of carcinoma cells occurs independently of the background mucosa. Regarding the degree of gastritis of background mucosa surrounding 143 H. pylori-positive differentiated-type adenocarcinomas, the mean score ranged from 1.497 to 1.713. Our data support the hypothesis that intestinal metaplasia is not a precancerous but a paracancerous lesion, and most gastric adenocarcinomas develop in mildly to moderately atrophic mucosa with H. pylori-infection, i.e., ongoing atrophy.
Kakinoki
Rie
R
Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.
Kushima
Ryoji
R
Matsubara
Akiko
A
Saito
Yasuharu
Y
Okabe
Hidetoshi
H
Fujiyama
Yoshihide
Y
Hattori
Takanori
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005752:Gastric Mucins / Q000032:analysis; D005756:Gastritis / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D010641:Phenotype; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology*
D005752:Gastric Mucins