Suzuki Y, Katayama Y, Fujimoto Y, Kobori I, Tamano M. Non-improvement of atrophic gastritis in cases of gastric cancer after successful Helicobacter pylori eradication therapy. World J Clin Cases 2024; 12(14): 2342-2349 [PMID: 38765755 DOI: 10.12998/wjcc.v12.i14.2342]
Corresponding Author of This Article
Yasumi Katayama, MD, PhD, Academic Research, Professor, Department of Gastroenterology, Dokkyo medical University Saitama Medical Center, Minami-Koshigaya 2-1-50, Saitama 343-8555, Japan. yasumi@dokkyomed.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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 Clin Cases. May 16, 2024; 12(14): 2342-2349 Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2342
Non-improvement of atrophic gastritis in cases of gastric cancer after successful Helicobacter pylori eradication therapy
Yuto Suzuki, Yasumi Katayama, Yo Fujimoto, Ikuhiro Kobori, Masaya Tamano
Yuto Suzuki, Yasumi Katayama, Yo Fujimoto, Ikuhiro Kobori, Masaya Tamano, Department of Gastroenterology, Dokkyo medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
Yasumi Katayama, Endoscopy Center, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
Author contributions: Suzuki Y, Katayama Y, and Fujimoto Y conceptualized and designed the study, collected data, carried out the initial analysis, and drafted the initial manuscript; Kobori I and Tamano M coordinated and supervised data collection and critically reviewed the manuscript for important intellectual content. All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Institutional review board statement: This study was approved by the ethics committee of the Dokkyo Medical University Saitama Medical Center (Approval No. 23036).
Informed consent statement: Patients were not required to give informed consent for the study because the analysis used anonymous clinical data that were obtained after each patient gave informed consent to treatment. For full disclosure, the details of this retrospective, observational study were published on the home page of the medical center.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
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: Yasumi Katayama, MD, PhD, Academic Research, Professor, Department of Gastroenterology, Dokkyo medical University Saitama Medical Center, Minami-Koshigaya 2-1-50, Saitama 343-8555, Japan. yasumi@dokkyomed.ac.jp
Received: January 21, 2024 Revised: February 16, 2024 Accepted: April 2, 2024 Published online: May 16, 2024
Abstract
BACKGROUND
Helicobacter pylori (H. pylori) infection is closely related to the development of gastric cancer (GC). However, GC can develop even after H. pylori eradication. Therefore, it would be extremely useful if GC could be predicted after eradication. The Kyoto classification score for gastritis (GA) is closely related to cancer risk. However, how the score for GC changes after eradication before onset is not well understood.
AIM
To investigate the characteristics of the progression of Kyoto classification scores for GC after H. pylori eradication.
METHODS
Eradication of H. pylori was confirmed in all patients using either the urea breath test or the stool antigen test. The Kyoto classification score of GC patients was evaluated by endoscopy at the time of event onset and three years earlier. In addition, the modified atrophy score was evaluated and compared between the GC group and the control GA group.
RESULTS
In total, 30 cases of early GC and 30 cases of chronic GA were evaluated. The pathology of the cancer cases was differentiated adenocarcinoma, except for one case of undifferentiated adenocarcinoma. The total score of the Kyoto classification was significantly higher in the GC group both at the time of cancer onset and three years earlier (4.97 vs 3.73, P = 0.0034; 4.2 vs 3.1, P = 0.0035, respectively). The modified atrophy score was significantly higher in the GC group both at the time of cancer onset and three years earlier and was significantly improved only in the GA group (5.3 vs 5.3, P = 0.5; 3.73 vs 3.1, P = 0.0475, respectively).
CONCLUSION
The course of the modified atrophy score is useful for predicting the onset of GC after eradication. Patients with severe atrophy after H. pylori eradication require careful monitoring.
Core Tip:Helicobacter pylori (H. pylori) infection is closely related to the development of gastric cancer (GC). Therefore, H. pylori eradication therapy is very important. However, GC can develop even after H. pylori eradication. Thus, it would be very useful if the onset of GC could be predicted. The Kyoto classification of gastritis is useful for endoscopic diagnosis. In this study, we showed that a modified atrophy score may be useful for predicting GC after eradication. In cases of GC after eradication, the modified atrophy score did not decrease during endoscopic follow-up. Gastric mucosal atrophic findings should be noted during post-eradication surveillance.
