Frequency of Helicobacter pylori -negative gastric cancer and gastric mucosal atrophy in a Japanese endoscopic submucosal dissection series including histological, endoscopic and serological atrophy.
BACKGROUND
The definition of Helicobacter pylori-negative gastric cancer depends on the accuracy of diagnosis of H. pylori infection. The aim of this study was to determine the frequency of H. pylori-negative gastric cancer and to clarify relationships with histological atrophy, endoscopic atrophy, and serological atrophy.


METHODS
A total of 240 early gastric cancers were included in this study. The status of H. pylori infection was determined from the rapid urease test, (13)C-urea breath test, H. pylori culture, histopathological examination and examination of IgG antibodies. In H. pylori-negative gastric cancer, histological atrophy and intestinal metaplasia, endoscopic atrophy and serological atrophy were assessed by pepsinogen.


RESULTS
The rate of H. pylori infection was 77.9% and 19 patients (7.9%) had a history of eradication. 34 patients (14.2%) were diagnosed with H. pylori-negative gastric cancer using diagnostic tools of H. pylori. However, most of the patients with H. pylori-negative gastric cancer had histological atrophy and intestinal metaplasia. Only 1 gastric cancer (0.42%) occurred in the mucosa without histological atrophy, endoscopic atrophy or serological atrophy.


CONCLUSIONS
Early gastric cancers in the Japanese endoscopic submucosal dissection series were strongly related to current or past infection with H. pylori and to gastric mucosal atrophy.
Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan. onosho@med.hokudai.ac.jp
Shouko
S
Ono
Mototsugu
M
Kato
Mio
M
Suzuki
Saori
S
Ishigaki
Masakazu
M
Takahashi
Masahira
M
Haneda
Katsuhiro
K
Mabe
Yuichi
Y
Shimizu
D000907:Antibodies, Bacterial / Q000097:blood*; D001284:Atrophy / Q000150:complications / Q000473:pathology; D001944:Breath Tests; D004210:Dissection; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007413:Intestinal Mucosa / Q000473:pathology*; D007564:Japan; D008679:Metaplasia / Q000150:complications / Q000473:pathology; D020116:Pepsinogen A / Q000097:blood; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D014510:Urease / Q000032:analysis
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D020116:Pepsinogen A; D014510:Urease