Characteristic Endoscopic Findings of Helicobacter pylori-Negative Early Gastric Undifferentiated Adenocarcinoma Junko Fujisaki 1 , Noriko Yamamoto 2 , Yusuke Horiuchi 1 , Hiroki Ohsumi 1 , Yuji Miyamoto 1 , Kenjiro Morisige 1 , Natsuko Yoshizawa 1 , Tomoka Taniguchi 1 , Masami Omae 1 , Hirotaka Ishikawa 1 , Toshiaki Hirasawa 1 , Akiyoshi Ishiyama 1 , Yorimasa Yamamoto 1 , Tomohiro Tsuchida 1 , Masahiro Igarashi 1 1Department of Gastroenterology, Cancer Institute Hospital of JFCR, Tokyo 2Department of Pathology, Cancer Institute Hospital of JFCR, Tokyo Keyword: H. pylori陰性 , 早期胃癌 , 未分化型腺癌 , ESD pp.854-861
Published Date 2014/5/25
DOI https://doi.org/10.11477/mf.1403114173
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 We examined 35 cases(19males and 16females)with 36 lesions of Helicobacter pylori(H. pylori)-negative early gastric undifferentiated adenocarcinoma. All cases had no history of H. pylori eradication, no inflammatory changes on the resected specimen, and no sign of atrophy on endoscopy, with negative results for pepsinogen and urea breath tests. Of the 36 lesions, 35 were diagnosed as signet-ring cell carcinoma, with only 1 case of poorly differentiated adenocarcinoma. The mean lesion size was 7.4mm. The macroscopic type was 0-IIc in 30 lesions and 0-IIb in 6 lesions. The depth classification was M in 36 lesions. Of the 36 intramucosal lesions, 13 were limited to the proliferative zone, 22 invaded from the proliferative zone to the upper side, and only 1 invaded the lower mucosa. With respect to the background mucosa, 25 lesions originated from the fundic gland area, 5 originated from the intermediate zone, and 6 originated from the pyloric glands. The incidence of HP-N-UDEGC was 2.3%of all ESD cases. These cases may have considerable relevance in the near future.

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