Predictive factors for metachronous gastric cancer in high-risk patients after successful Helicobacter pylori eradication.

Abstract

BACKGROUND:

Helicobacter pylori eradication following endoscopic mucosal resection of early gastric cancer reduces the risk of metachronous gastric cancer.

AIM:

To identify subgroups of differing cancer risk after endoscopic mucosal resection of early gastric cancer.

METHODS:

Histological assessment of antral and corpus tissue was done by the updated Sydney Classification and serum pepsinogen I and II levels were measured using ELISA kits. Infected patients were treated with a 7-day regimen consisting of amoxicillin, clarithromycin and a proton pump inhibitor.

RESULTS:

100 patients were enrolled; in 80 patients H. pylori was successfully eradicated and they were followed up for more than 2 years (median observation period 33 months). Metachronous gastric cancers developed in 9 patients after successful eradication. All cases were men. The frequency of severe atrophy assessed by histology (100 vs. 53.2%, p = 0.03) was higher and pepsinogen I/II ratio before eradication was significantly lower in the group that developed cancer compared to the group that did not. Pepsinogen I <25 ng/ml was significantly associated with development of a new lesion.

CONCLUSIONS:

The cancer risk after eradication correlated with the severity of corpus atrophy. It should be possible to identify subgroups requiring intensive and less intensive surveillance after eradication.

• Authors: Akiko Shiotani, Noriya Uedo, Hiroyasu Iishi, Yamanaka Yoshiyuki, Manabu Ishii, Noriaki Manabe, Tomoari Kamada, Hiroaki Kusunoki, Jiro Hata, Ken Haruma
• Journal: Digestion (Digestion) Vol. 78 Issue 2-3 Pg. 113-9 ( 2008) ISSN: 1421-9867 [Electronic] Switzerland
• PMID: 19023205 (Publication Type: Journal Article)
• Copyright: Copyright 2008 S. Karger AG, Basel.

Chemical References

• Pepsinogen C
• Pepsinogen A

Topics

• Female
• Helicobacter Infections (complications, drug therapy)
• Humans
• Male
• Middle Aged
• Neoplasms, Second Primary (pathology)
• Pepsinogen A (blood)
• Pepsinogen C (blood)
• Predictive Value of Tests
• Risk Factors
• Stomach Neoplasms (etiology, pathology)