Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development.
Helicobacter pylori (H. pylori) infection is well known to be associated with the development of precancerous lesions such as chronic atrophic gastritis (AG), or gastric intestinal metaplasia (GIM), and cancer. Various molecular alterations are identified not only in gastric cancer (GC) but also in precancerous lesions. H. pylori treatment seems to improve AG and GIM, but still remains controversial. In contrast, many studies, including meta-analysis, show that H. pylori eradication reduces GC. Molecular markers detected by genetic and epigenetic alterations related to carcinogenesis reverse following H. pylori eradication. This indicates that these changes may be an important factor in the identification of high risk patients for cancer development. Patients who underwent endoscopic treatment of GC are at high risk for development of metachronous GC. A randomized controlled trial from Japan concluded that prophylactic eradication of H. pylori after endoscopic resection should be used to prevent the development of metachronous GC, but recent retrospective studies did not show the tendency. Patients with precancerous lesions (molecular alterations) that do not reverse after H. pylori treatment, represent the "point of no return" and may be at high risk for the development of GC. Therefore, earlier H. pylori eradication should be considered for preventing GC development prior to the appearance of precancerous lesions.
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Jiro
J
Watari
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Nancy
N
Chen
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Peter S
PS
Amenta
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Hirokazu
H
Fukui
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Tadayuki
T
Oshima
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Toshihiko
T
Tomita
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Hiroto
H
Miwa
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Kheng-Jim
KJ
Lim
Jiro Watari, Hirokazu Fukui, Tadayuki Oshima, Toshihiko Tomita, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
Kiron M
KM
Das
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D005756:Gastritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology* / Q000517:prevention & control; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology* / Q000517:prevention & control; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
Eradication; Gastric atrophy; Gastric cancer; Helicobacter pylori; Intestinal metaplasia; Molecular alteration; Prevention