胃粘膜萎縮やH. pylori感染状況と食道胃接合部腺癌の特徴—当院における早期食道胃接合部腺癌の発生率の年次推移

Characteristics of Esophagogastric Junction Adenocarcinoma in Relation to Gastric Mucosal Atrophy and Helicobacter pylori Infection Status:Time Trends in the Incidence of Superficial Esophagogastric Junction Adenocarcinoma in Our Institute

要旨●本邦の食道胃接合部腺癌のデータは限られている．2007〜2024年の期間に当院で治療された早期食道胃接合部腺癌298例を対象に，臨床病理学的特徴の年次推移を後方視的に検討した．萎縮性胃炎の頻度は有意に減少し，一方でBarrett食道，腫瘍中心が食道胃接合部より口側の病変，およびBarrett食道癌の割合が有意に増加した．腫瘍の周在位置において，右下方向の病変が有意に減少し，左下方向の病変が有意に増加した．H. pylori感染率の低下により萎縮性胃炎の頻度が減少し，それに伴う胃酸分泌能の回復，逆流性食道炎やBarrett食道の増加が本結果に関連している可能性がある．

　There is a paucity of data on esophagogastric junction（EGJ）cancer in Japan. In this study, we retrospectively analyzed the time trends in clinicopathological features of 298 patients with early EGJ adenocarcinoma treated at our institution between 2007 and 2024. There was a significant decrease in the prevalence of atrophic gastritis over time, while the rates of background Barrett's esophagus, tumors located on the oral side of the EGJ, and Barrett's adenocarcinoma significantly increased over time. The prevalence of tumor lesions on the right lower side significantly decreased over time, whereas the prevalence of those on the left lower side significantly increased over time. These changes may be associated with a decrease in Helicobacter pylori infection, leading to reduced atrophic gastritis, recovery of gastric acid secretion, and subsequent increases in the rates of reflux esophagitis and Barrett's mucosa.