Endoscopic and clinicopathological features of Helicobacter pylori-negative early gastric cancer
10.3760/cma.j.cn321463-20240625-00219
- VernacularTitle:幽门螺杆菌阴性早期胃癌的内镜及临床病理特征分析
- Author:
Weihua WANG
1
;
Fuguo LIU
;
Xuan ZHOU
;
Yuning CHU
;
Zibin TIAN
Author Information
1. 青岛大学附属医院消化内科，青岛 266000
- Publication Type:Journal Article
- Keywords:
Gastroscopy;
Helicobacter pylori-negative gastric cancer;
Early gastric cancer;
Clinicopathology
- From:
Chinese Journal of Digestive Endoscopy
2025;42(8):608-615
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the endoscopic and clinicopathological characteristics of Helicobacter pylori ( HP)-negative early gastric cancer (EGC). Methods:A retrospective study was conducted on data of patients who were diagnosed as having EGC at the Affiliated Hospital of Qingdao University between June 2013 and March 2024. Cases meeting the diagnostic criteria for HP-negative status were included. Endoscopic findings and histopathological features of HP-negative EGC were systematically analyzed. Results:Among 698 EGC patients, 29 (4.2%) were identified as HP-negative. The age at diagnosis was 59.9±10.0 years, with marked female predominance (69.0%, 20/29 VS 31.0% males, 9/29). A body mass index ≥24 kg/m 2 was observed in 69.0% (20/29). Regarding therapeutic approaches, endoscopic submucosal dissection was performed in 89.7% (26/29). Among the 29 patients with a total of 30 lesions, the majority were localized to the middle third of the stomach (40.0%, 12/30), or the upper third (36.7%, 11/30). Differentiated-type accounted for 73.3% (22/30) among the histological types, including 13 oxyntic gland adenoma (OGA) / gastric adenocarcinoma of fundic-gland type (GA-FG) (upper third: 7; middle third: 6), and 2 gastric adenocarcinomas of fundic-gland mucosa type (GA-FGM) (both upper third). White-light endoscopy revealed polypoid or small submucosal tumor-like protrusions with whitish or erythematous discoloration and characteristic branching dilated vessels on the surface. Among the OGA/GA-FG lesions, 8 exhibited indistinct demarcation lines (DL). Additionally, both GA-FGM lesions demonstrated poorly defined DL. Three gastric adenocarcinomas of foveolar-type (GA-FV) were identified (upper/middle/lower third: 1 each), with 2 presenting as erythematous elevated masses. Five signet ring cell carcinomas (upper/middle/lower third: 1/3/1) exhibited flat or shallow depressed morphology with whitish or erythematous discoloration under white-light endoscopy; 3 exhibited well-demarcated borders. Four pyloric gland adenocarcinomas and three poorly differentiated tubular adenocarcinomas showed no significant differences in endoscopic features on white-light and narrow-band imaging compared to HP-positive EGC. No intestinal-type adenocarcinomas were identified. Conclusion:HP-negative EGC exhibit distinct endoscopic and clinicopathological characteristics, including female predominance and frequent differentiated histology, and upper/middle-third localization of elevated lesions, primarily OGA/GA-FG.
