title: A case of Helicobacter pylori-negative intramucosal well-differentiated gastric adenocarcinoma with intestinal phenotype.
abstract: A woman in her 30s visited our hospital with stool abnormality. Esophagogastroduodenoscopy revealed a depressed lesion on the greater curvature of the gastric antrum. The tumor was diagnosed as a well-differentiated tubular adenocarcinoma based on the analysis of the biopsy specimen. The rapid urease test, histological examination, and serum anti-Helicobacter pylori antibody indicated that the patient was Helicobacter pylori negative. Gastric mucosal atrophy was not evident on esophagogastroduodenoscopy. Complete cure en bloc resection was successfully performed. The tumor was confined to the mucosa (pT1a-M). Immunohistochemistry showed positive CD10, MUC2, and CDX2 expression and negative MUC5AC and MUC6 expression. Thus, the phenotype was diagnosed as the intestinal phenotype. Helicobacter pylori-negative, well-differentiated early gastric cancer with intestinal phenotype has not been previously reported. Here, we report a rare and valuable case of Helicobacter pylori-negative early gastric cancer with intestinal phenotype treated by endoscopic submucosal dissection.
authors.affiliation: Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suto
authors.forename: Takuto
authors.initials: T
authors.lastname: Nosaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Naito
authors.forename: Kazuto
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ofuji
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Matsuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohtani
authors.forename: Katsushi
authors.initials: K
authors.lastname: Hiramatsu
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nemoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Imamura
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Nakamoto
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000071616:CDX2 Transcription Factor; D004210:Dissection; D004384:Duodenoscopy; D004945:Esophagoscopy; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005773:Gastroscopy; D016480:Helicobacter pylori; D018398:Homeodomain Proteins / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D055262:Mucin-2 / Q000378:metabolism; D015260:Neprilysin / Q000378:metabolism; D010641:Phenotype; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; C524625:MUC2 protein, human; D055262:Mucin-2; D015260:Neprilysin