Kishikawa H, Nishida J. Gastric cancer in patients with Helicobacter pylori-negative autoimmune gastritis. World J Gastrointest Oncol 2025; 17(4): 101661 [DOI: 10.4251/wjgo.v17.i4.101661]
Corresponding Author of This Article
Hiroshi Kishikawa, MD, PhD, Associate Professor, Department of Gastroenterology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, Ichikawa 272-8513, Chiba, Japan. kisikawa@tdc.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Apr 15, 2025; 17(4): 101661 Published online Apr 15, 2025. doi: 10.4251/wjgo.v17.i4.101661
Gastric cancer in patients with Helicobacter pylori-negative autoimmune gastritis
Hiroshi Kishikawa, Jiro Nishida
Hiroshi Kishikawa, Jiro Nishida, Department of Gastroenterology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa 272-8513, Chiba, Japan
Author contributions: Kishikawa H contributed to the conception, design, and drafting of the article; Nishida J contributed to editing and supervising this study; All authors have approved the final draft submitted.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hiroshi Kishikawa, MD, PhD, Associate Professor, Department of Gastroenterology, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, Ichikawa 272-8513, Chiba, Japan. kisikawa@tdc.ac.jp
Received: September 23, 2024 Revised: January 6, 2025 Accepted: January 20, 2025 Published online: April 15, 2025 Processing time: 183 Days and 10 Hours
Abstract
Although Helicobacter pylori (H. pylori) is implicated in the development of most cases of gastric cancer with autoimmune gastritis, cases of gastric cancer have been reported in patients testing negative for H. pylori. Here, we aimed to outline the current research status of the factors involved in the development of gastric cancer in H. pylori-negative autoimmune gastritis. Predictive pathological conditions for the development of gastric cancer in H. pylori-negative autoimmune gastritis are postulated to be: (1) Severe atrophy; (2) Hypergastrinemia; (3) Bile reflux; and (4) Low acidity, which are directly related to the pathophysiology of autoimmune gastritis, as well as smoking and family history, which are not related to autoimmune gastritis. In autoimmune gastritis, where there is a possibility of spontaneous disappearance of H. pylori in advanced atrophy, it is difficult to assess H. pylori. Since H. pylori infection begins in the antrum and subsequently progresses to the proximal stomach, it is interpreted as H. pylori-negative autoimmune gastritis if histologically consistent with autoimmune gastritis in the body with spared antrum, and negative for other H. pylori tests. However, it is essential to examine whether the currently prevailing histological interpretation used to evaluate H. pylori infection status is appropriate.
Core Tip: Although in cases of autoimmune gastritis, Helicobacter pylori (H. pylori) is often implicated in gastric cancer development, there are reports of gastric cancer in patients with H. pylori-negative cases. Pathological factors for the development of gastric cancer in H. pylori-negative autoimmune gastritis include severe atrophy, hypergastrinemia, bile reflux, and low acidity. In the diagnosis of H. pylori infection in autoimmune gastritis, it is difficult to accurately diagnose cases of previous infection. When current H. pylori infection is ruled out in autoimmune gastritis sparing antrum, the patient is considered H. pylori-negative; however, this should be re-evaluated in the future.
