Departments of Gastroenterology, Nippon Medical School Hospital, Tokyo, Japan.
Departments of Pathology, Nippon Medical School Hospital, Tokyo, Japan.
PLoS One. 2021 Mar 10;16(3):e0248333. doi: 10.1371/journal.pone.0248333. eCollection 2021.
A non-neoplastic epithelium (NE) often appears in gastric cancer (GC). We explored the histological features of NE in comparison between HP-eradicated and HP-infected GCs. We enrolled 40 HP-eradicated and 40 HP-infected GCs matched by size, macroscopic and histological type. NE was classified into full gland type and surface type; the former was a non-neoplastic gland isolated within cancer, and the latter was NE on the surface of the cancer. Surface type was additionally divided into NE at the cancer margin (marginal surface type) and NE inside cancer (internal surface type). The primary endpoints were the frequency and the length ratio (the ratio to cancer length) of NE. The secondary endpoints were the relationships between NE and clinicopathological factors, including endoscopic findings of a gastritis-like appearance (GLA), reddish depressed lesion (RDL), and white nodular mucosa (WNM). The frequency and length ratio of the internal surface type in HP-eradicated GCs were significantly higher (82.5% vs 50%, P = 0.005) and larger (11.6 ± 10.6 vs 4.2 ± 9.9, P < 0.001) than those in HP-infected GCs, and the increase was more significant according to the passage of time since HP eradication. The frequency and length ratio of marginal surface type and full gland type were not significantly different between the two groups, but the coexistence of internal surface and full gland types was statistically significant (p < 0.001). The frequencies of GLA, RDLs, and WNM in HP-eradicated GCs were significantly higher than those in HP-infected GCs. GLA-positive GCs were covered more widely by internal surface type than GLA-negative GCs (13.3% vs. 6.6%, P = 0.003). Various types of NE were noted in gastric cancer, and the internal surface type of NE was shown to be significantly linked to HP-eradicated cancer and GLA.
一种非肿瘤性上皮（NE）常出现在胃癌（GC）中。我们通过比较 HP 根除和 HP 感染的 GC 来探讨 NE 的组织学特征。我们纳入了 40 例 HP 根除和 40 例大小、大体和组织学类型相匹配的 HP 感染 GC。将 NE 分为全腺体型和表面型；前者是孤立于癌内的非肿瘤性腺体，后者是癌表面的 NE。表面型进一步分为癌缘的 NE（边缘表面型）和癌内的 NE（内部表面型）。主要终点是 NE 的频率和长度比（与癌症长度的比值）。次要终点是 NE 与临床病理因素的关系，包括胃炎样外观（GLA）、红色凹陷病变（RDL）和白色结节状黏膜（WNM）的内镜发现。HP 根除 GC 中内部表面型的频率和长度比明显高于（82.5%比 50%，P = 0.005）和更大（11.6 ± 10.6 比 4.2 ± 9.9，P < 0.001），HP 根除后时间的推移使这种增加更为显著。边缘表面型和全腺体型的频率和长度比在两组之间无显著差异，但内部表面型和全腺体型的共存具有统计学意义（p < 0.001）。HP 根除 GC 中 GLA、RDL 和 WNM 的频率明显高于 HP 感染 GC。GLA 阳性 GC 的内部表面型覆盖范围明显大于 GLA 阴性 GC（13.3%比 6.6%，P = 0.003）。在胃癌中发现了各种类型的 NE，并且内部表面型的 NE 与 HP 根除的癌症和 GLA 显著相关。
