Department of Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan.
Digestion. 2012;85(1):61-7. doi: 10.1159/000335260. Epub 2012 Jan 5.
Along with the widespread use of eradication for Helicobacter pylori (H. pylori), the incidence of gastric cancer after eradication has also been increasing. There is a need for clarification of the clinical and biological characteristics of these neoplasms.
We studied 27 cases of gastric cancer that developed after eradication (group AE). Out of the 27, we selected 26 with early-stage gastric cancer and compared them with 78 age-matched gastric cancer patients with H. pylori infection (group Pos) and 20 patients without H. pylori (group Neg). The patient with autoimmune gastritis was not included. Clinicopathological features, mucus patterns and Wnt5a expressions were compared among these groups.
Among group AE patients, there were more males than females, and the tumor histology was mainly intestinal type, a significant difference from group Neg. In contrast, macroscopically, the tumors were predominantly of the flat-depressed type, a feature similar to that of group Neg but significantly different from that of group Pos. MUC2 and Wnt5a expression was significantly lower in group AE than in group Pos.
Gastric cancer development after eradication may have a carcinogenic pathway similar to that in cancer with H. pylori infection, though macroscopic/biological features may be modified by eradication therapy.
随着幽门螺杆菌（H. pylori）根除的广泛应用，根除后胃癌的发病率也在增加。有必要阐明这些肿瘤的临床和生物学特征。
我们研究了 27 例根除后患胃癌的病例（AE 组）。在这 27 例中，我们选择了 26 例早期胃癌患者，并将其与 78 例年龄匹配的 H. pylori 感染胃癌患者（阳性组）和 20 例无 H. pylori 患者（阴性组）进行比较。不包括自身免疫性胃炎患者。比较了这些组之间的临床病理特征、黏液模式和 Wnt5a 表达。
AE 组患者中男性多于女性，肿瘤组织学主要为肠型，与阴性组有显著差异。相比之下，宏观上，肿瘤主要为平坦凹陷型，与阴性组相似，但与阳性组有显著差异。AE 组的 MUC2 和 Wnt5a 表达明显低于阳性组。
根除后胃癌的发生可能具有与 H. pylori 感染相关的致癌途径，尽管宏观/生物学特征可能因根除治疗而改变。
