title: Histological evaluation of patients with gastritis at high risk of developing gastric cancer using a conventional index.
abstract: Although gastric cancer (GCa) is strongly associated with Helicobacter pylori infection, only some H. pylori-positive subjects develop gastric cancer. The aim of this study is to identify H. pylori-positive subjects at high risk of developing GCa by assessment of the histopathological findings in the non-cancer-containing mucosa of patients with and without GCa. The subjects were 35 patients with diffuse-type gastric cancer (D-GCa), 55 with intestinal-type gastric cancer (I-GCa), and 99 H. pylori-positive controls without GCa. Two specimens were taken from the greater curvature of the antrum and the middle body. Histopathological gradings were evaluated using the updated Sydney System, and the risk of GCa was evaluated using a modified Meining's gastric cancer risk index (GCRI). Among the H. pylori-positive controls, corpus gastritis was seen in 98.0% (97/99) and corpus atrophic gastritis in 78.8% (78/99). The mean GCRI for the D-GCa (5.514±2.03) and I-GCa (6.836±2.08) groups was significantly greater than that for the H. pylori-positive controls (4.071±2.07; p=0.0005, p<0.0001). In addition, the mean GCRI for the I-GCa group was significantly greater than that for the D-GCa group (p<0.005). The GCRI-positive rate was significantly higher in subjects with GCa than in H. pylori-positive controls (D-GCa: p<0.005, I-GCa: p<0.0001). Many H. pylori-positive Japanese still carry a high risk for gastric cancer. However, H. pylori-positive patients at high risk of developing GCa (not only intestinal-type but also diffuse-type) may be detected using a simple GCRI.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Tanaka
authors.forename: Tomoari
authors.initials: T
authors.lastname: Kamada
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Inoue
authors.forename: Akiko
authors.initials: A
authors.lastname: Shiotani
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kusunoki
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Jiro
authors.initials: J
authors.lastname: Hata
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
mesh_terms: D044466:Asian People; D001284:Atrophy; D001706:Biopsy; D002277:Carcinoma / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005756:Gastritis / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000208:ethnology / Q000382:microbiology / Q000473:pathology*