The Eradication of Helicobacter pylori for Patients with Gastric Adenoma Takuji Gotoda 1 , Hitoshi Kondo 2 , Ichiro Oda 1 1Department of Endoscopy, National Cancer Center Hospital 2Department of Gastroenterology, Tonan Hospital Keyword: 胃腺腫 , H.pylori , 除菌療法 , 粘液形質 pp.569-574
Published Date 2002/3/25
DOI https://doi.org/10.11477/mf.1403103494
  • Abstract
  • Look Inside
  • Cited by

 Although epidemiological studies strongly suggest a causal link between Helicobacter pylori (H. pylori ) infection and gastric carcinogenesis via a multistage process, no direct association between them has been demonstrated. To clarify the causal link between H. pylori infection and gastric neoplastic lesions, several investigations concerning the reversibility of gastric adenoma after the eradication of H. pylori have been reported. There is, however, not yet a consensus of opinion. Long observation was then carried out endoscopically and histologically in 25 patients with gastric adenoma who had been treated for H. pylori. Furthermore, mucin phenotypic expression of their adenoma was evaluated immunohistochemically. Thirteen adenomas (52%) showed macroscopic changes. Among them, no neoplasia was histologically confirmed in 7 patients (28%) whose adenoma could not be endoscopically detected. On the other hand, 6 adenomas (24%) showed apparent regression upon follow-up. The histological grade of these adenomas remained stable. There was no difference of mucin phenotype between the regressed and the unchanged groups. From our results, we should consider two possibilities. First, the improvement of histological grade in gastric adenoma may occur after the endoscopic disappearance of gastric adenoma. Second, the eradication of H. pylori may result in more prominent intestinal metaplasia, which may mask a gastric adenoma. We say this because we found that the endoscopic configuration was modified by the regression of edema or inflammation after the removal of H. pylori.

Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院