Influence of Helicobacter pylori Infection on Endoscopic Findings of Gastric Adenocarcinoma of the Fundic Gland Type

Fumiaki Ishibashi; Keita Fukushima; Takashi Ito; Konomi Kobayashi; Ryu Tanaka; Ryoichi Onizuka

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자료유형: 학술저널

저자정보: Fumiaki Ishibashi Keita Fukushima Takashi Ito Konomi Kobayashi Ryu Tanaka Ryoichi Onizuka

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제19권 제2호

발행연도: 2019.1

수록면: 225 - 233 (9page)

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Purpose: Gastric adenocarcinoma of the fundic gland type (chief cell predominant type) (GA-FG-CCP) was first reported as a rare adenocarcinoma found in the normal fundic mucosa. Recent studies have proposed the possibility that GA-FG-CCPs were also generated in the atrophic mucosa after Helicobacter pylori (HP) eradication therapy. However, little is known on the endoscopic findings of GA-FG-CCP generated in the atrophic mucosa due to its extreme rarity. Materials and Methods: A total of 8 patients who underwent endoscopic submucosal resection and were diagnosed with GA-FG-CCP generated in the HP-uninfected mucosa (4 cases, HP-uninfected group) or HP-eradicated atrophic mucosa (4 cases, HP-eradicated group) were retrospectively analyzed, and their endoscopic findings, including magnifying endoscopy with narrow band imaging (M-NBI), and pathological features were compared. Results: While GA-FG-CCPs in the 2 groups displayed similar macroscopic appearance, M-NBI demonstrated that characteristic microvessels (tapered microvessels like withered branches) were specifically identified in the HP-eradicated group. Pathological investigation revealed that a decreasing number of fundic glands and thinned foveolar epithelium covering tumor ducts were thought to lower the thickness of the covering layer over tumor ducts in the HP-eradicated group. Moreover, dilation of vessels just under the surface of the lesions contributed to the visualization of microvessels by M-NBI. Conclusions: The change in background mucosa due to HP infection influenced the thickness of the covering layer over the tumor ducts and M-NBI finding of GA-FG-CCP.

참고문헌 (20)

참고문헌 신청

Helicobacter and Cancer Collaborative Group / 2001 / Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts / Gut 49:347~353

Wang C / 2007 / The association between Helicobacter pylori infection and early gastric cancer: a meta-analysis / Am J Gastroenterol 102:1789~1798

Nakamura K / 1968 / Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances / Gan 59:251~258

Lauren P / 1965 / The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classification / Acta Pathol Microbiol Scand 64:31~49

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