title: Biomarkers predicting development of metachronous gastric cancer after endoscopic resection: an analysis of molecular pathology of Helicobacter pylori eradication.
abstract: Metachronous gastric cancer (MGC) after endoscopic resection (ER) of gastric cancer still occurs to some degree even after Helicobacter pylori (H. pylori) treatment. We evaluated whether two biomarkers related to carcinogenesis expressed in intestinal metaplasia (IM) become predictors for MGC development after eradication. We performed a hospital-based, case-control study of 75 patients, including 50 mucosal cancer patients who had undergone ER (Group DYS), and 25 age- and sex-matched chronic gastritis patients for whom H. pylori had been successfully eradicated (control). Additionally, Group DYS patients were divided into two groups: 25 successfully H. pylori-eradicated (eradicated group) and 25 un-eradicated patients (persistent group). All patients were followed for 1 year. We analyzed microsatellite instability (MSI) and immunoperoxidase assays using a monoclonal antibody for the colonic phenotype (Das-1). Both MSI and Das-1 reactivity in IM were significantly higher in Group DYS than in the control (p < 0.05 and p < 0.01, respectively). MSI and Das-1 reactivity were strong and independent predictors for gastric cancer (OR = 7.09, 95% CI 1.27-39.6, p = 0.03 for MSI and OR = 4.96, 95% CI 1.64-15.0, p = 0.005 for Das-1 reactivity). The incidence of MSI tended to decrease in the eradicated group (p = 0.07), but not in the persistent group. The Das-1 immunoreactivity in IM also declined in both the eradicated group and the control. Interestingly, all MGCs after ER were positive for MSI or Das-1 reactivity. MSI or Das-1 reactivity in IM strongly predicts the development of MGC. Patients in whom these biomarkers persist after eradication may therefore have a high risk of developing MGC.
authors: Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. watarij@hyo-med.ac.jp
authors: Jiro
authors: J
authors: Watari
authors: Kentaro
authors: K
authors: Moriichi
authors: Hiroki
authors: H
authors: Tanabe
authors: Shin
authors: S
authors: Kashima
authors: Yoshiki
authors: Y
authors: Nomura
authors: Mikihiro
authors: M
authors: Fujiya
authors: Toshihiko
authors: T
authors: Tomita
authors: Tadayuki
authors: T
authors: Oshima
authors: Hirokazu
authors: H
authors: Fukui
authors: Hiroto
authors: H
authors: Miwa
authors: Kiron M
authors: KM
authors: Das
authors: Yutaka
authors: Y
authors: Kohgo
mesh_terms: D000368:Aged; D000906:Antibodies / Q000032:analysis*; D015415:Biomarkers / Q000032:analysis*; D016022:Case-Control Studies; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000235:genetics; D016481:Helicobacter Infections / Q000150:complications / Q000235:genetics* / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D013274:Stomach Neoplasms / Q000150:complications / Q000235:genetics* / Q000601:surgery
chemical_list: D000906:Antibodies; D015415:Biomarkers; C467479:DAS-1 protein, human