Teshima Hajime, Kotachi Takahiro, Kuwai Toshio, Tsuboi Akiyoshi, Tanaka Hidenori, Yamashita Ken, Takigawa Hidehiko, Kishida Yoshihiro, Urabe Yuji, Oka Shiro
Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Japan.
Gastrointestinal Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan.
Cancers (Basel). 2024 Sep 14;16(18):3154. doi: 10.3390/cancers16183154.
BACKGROUND/OBJECTIVES: Eradication therapy for gastritis was approved for insurance coverage by the Japanese government in 2013. Since then, the incidence of gastric cancer discovered after eradication (GCAE) has increased. However, there are only a few reports of GCAE diagnosed more than 10 years after eradication. We investigated the clinicopathological characteristics of early-stage GCAE, including histological types and the interval from eradication to diagnosis.
Overall, 379 patients with a total of 448 GCAE lesions treated with endoscopic resection or surgery at our hospital between January 2015 and December 2021 were assessed, and 315 patients with a known interval from eradication to diagnosis of GCAE with a total of 354 lesions were included. We classified the cases into two groups: differentiated-type GCAE (D-GCAE; 279 patients, 318 lesions) and undifferentiated-type GCAE (UD-GCAE; 36 patients, 36 lesions).
Smoking and a mild-to-moderate degree of atrophy were risk factors associated with differentiated-type gastric cancer occurring more than 10 years after eradication. Additionally, the rate of a mixture of histological types with relatively high malignant potential was significantly higher in UD-GCAE presenting more than 10 years after eradication group than those presenting within 10 years after eradication.
背景/目的:2013年日本政府批准了胃炎根除疗法的保险覆盖范围。自那时以来,根除后发现的胃癌(GCAE)发病率有所上升。然而,关于根除后10年以上诊断出的GCAE的报告很少。我们调查了早期GCAE的临床病理特征,包括组织学类型以及从根除到诊断的间隔时间。
我们评估了2015年1月至2021年12月期间在我院接受内镜切除或手术治疗的379例共448个GCAE病变患者,纳入了315例已知从根除到诊断GCAE间隔时间的患者,共354个病变。我们将病例分为两组:分化型GCAE(D-GCAE;279例患者,318个病变)和未分化型GCAE(UD-GCAE;36例患者,36个病变)。
吸烟和轻度至中度萎缩是与根除后10年以上发生的分化型胃癌相关的危险因素。此外,根除后10年以上出现的UD-GCAE组中,具有相对较高恶性潜能的组织学类型混合率明显高于根除后10年内出现的组。