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幽门螺杆菌根除治疗后短期随访中人类胃肿瘤的形态学变化

Morphological changes in human gastric tumours after eradication therapy of Helicobacter pylori in a short-term follow-up.

作者信息

Ito M, Tanaka S, Takata S, Oka S, Imagawa S, Ueda H, Egi Y, Kitadai Y, Yasui W, Yoshihara M, Haruma K, Chayama K

机构信息

Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, Japan.

出版信息

Aliment Pharmacol Ther. 2005 Mar 1;21(5):559-66. doi: 10.1111/j.1365-2036.2005.02360.x.

Abstract

BACKGROUND

It is controversial as to whether the development of gastric cancer is influenced by Helicobacter pylori eradication. If eradication itself influences the tumour morphology, this may affect the tumour discovery rate.

AIM

To investigate the morphological changes in the gastric neoplasm after H. pylori eradication.

METHODS

We studied 37 patients with eradication therapy. After a 1-month follow-up, endoscopic re-evaluation was performed and the appearance was compared with first image. All lesions were resected endoscopically, and were subjected to histological assessment and to immunohistochemistry. Serum gastrin levels were determined before and after eradication.

RESULTS

Twenty-nine of 37 patients underwent successful eradication. The appearance of 11 lesions (33% of 33 lesions) became indistinct after successful eradication. All lesions were of the superficial-elevated type and the height of the lesions decreased. We detected normal columnar epithelium over the neoplasm in eight of the lesions. Higher expression of single-stranded deoxyribonucleic acid in the deep area was characteristic in tumours with an indistinct appearance. These changes did not correlate with the serum gastrin levels.

CONCLUSIONS

The morphology of the gastric neoplasm change after eradication in the short-term. This may contribute to the decreased tumour discovery rate.

摘要

背景

幽门螺杆菌根除是否会影响胃癌的发生仍存在争议。如果根除本身会影响肿瘤形态,这可能会影响肿瘤的发现率。

目的

研究幽门螺杆菌根除后胃肿瘤的形态学变化。

方法

我们对37例接受根除治疗的患者进行了研究。经过1个月的随访后,进行了内镜复查,并将外观与首次图像进行了比较。所有病变均通过内镜切除,并进行组织学评估和免疫组织化学检查。在根除前后测定血清胃泌素水平。

结果

37例患者中有29例成功根除。成功根除后,11个病变(33个病变中的33%)的外观变得不清晰。所有病变均为浅表隆起型,病变高度降低。我们在8个病变的肿瘤上检测到正常柱状上皮。外观不清晰的肿瘤在深部区域单链脱氧核糖核酸表达较高是其特征。这些变化与血清胃泌素水平无关。

结论

根除后短期内胃肿瘤的形态会发生变化。这可能导致肿瘤发现率降低。

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