title: Actual Status of Involvement of Helicobacter pylori Infection That Developed Gastric Cancer from Group A of ABC (D) Stratification - Study of Early Gastric Cancer Cases That Underwent Endoscopic Submucosal Dissection.
abstract: OBJECTIVE
  Patients who are Helicobacter pylori antibody negative and have normal pepsinogen (PG) levels (group A of ABC (D) stratification) are considered unlikely to develop gastric cancer. This study aimed to clarify the involvement (uninfection, present infection or previous infection) of H. pylori in group A patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) by examining their background gastric mucosa endoscopically and histologically.
  
  
  METHODS
  This study included 166 patients with gastric cancer who were treated by ESD. Patients were classified according to PG levels and H. pylori antibody titers. Three biopsies (greater curvature of the antrum, lesser curvature of the middle corpus and greater curvature of the middle corpus) from group A were histologically analyzed and compared with those of groups B, C, D and after eradication).
  
  
  RESULTS
  In group A (34 patients), 32 patients had endoscopic atrophy (group A'). Histological neutrophil activity, chronic inflammation and atrophy scores were lower in group A' than in other groups. Group A' scores were similar to those of the after eradication group.
  
  
  CONCLUSIONS
  Most of the group A patients with early gastric cancer were not uninfected with H. pylori, but had previous infections, thus carrying carcinogenic risk.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Miura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Kouno
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Masaya
authors.initials: M
authors.lastname: Iwamuro
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hori
authors.forename: Masahide
authors.initials: M
authors.lastname: Kita
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawano
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Takehiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yanai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D055088:Early Detection of Cancer; D000069916:Endoscopic Mucosal Resection; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000601:surgery*
chemical_list: D020116:Pepsinogen A