Influence of Helicobacter pylori Infection on Endoscopic Findings of Gastric Adenocarcinoma of the Fundic Gland Type
- Author:
Fumiaki ISHIBASHI
1
;
Keita FUKUSHIMA
;
Takashi ITO
;
Konomi KOBAYASHI
;
Ryu TANAKA
;
Ryoichi ONIZUKA
Author Information
- Publication Type:Original Article
- Keywords: Gastric cancer; Helicobacter pylori; Narrow band imaging
- MeSH: Adenocarcinoma; Endoscopy; Epithelium; Helicobacter pylori; Helicobacter; Humans; Microvessels; Mucous Membrane; Narrow Band Imaging; Retrospective Studies; Stomach Neoplasms
- From:Journal of Gastric Cancer 2019;19(2):225-233
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
