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Endoscopic and Histological Changes of Gastric Adenoma after Helicobacter pylori Eradication Sho Suzuki 1 , Takuji Gotoda 1 , Haruhisa Suzuki 2 , Masakazu Abe 1 , Maya Suguro 1 , Mikinori Koga 1 , Shin Kono 1 , Naoko Yagi 1 , Chika Kusano 1 , Masakatsu Fukuzawa 3 , Ichiro Oda 2 , Shigeki Sekine 4 , Takashi Kawai 3 , Fuminori Moriyasu 1 1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 2Endoscopy Division, National Cancer Center Hospital, Tokyo 3Endoscopy Center, Tokyo Medical University Hospital, Tokyo 4Pathology Division, National Cancer Center Hospital, Tokyo Keyword: 胃腺腫 , Helicobacter pylori , 除菌治療 , 除菌後経過 pp.1871-1878
Published Date 2014/12/25
DOI https://doi.org/10.11477/mf.1403200113
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 Backgrounds and Aims : Helicobacter pylori infection causes gastric adenoma and gastric cancer through the development of chronic atrophic gastritis and intestinal metaplasia. The effect of H. pylori eradication on existing gastric neoplasia is unknown. This study investigated the efficacy of H. pylori eradication therapy on existing gastric adenoma.

 Material and Methods : We prospectively reviewed 27 patients with gastric adenoma who underwent H. pylori eradication therapy between April and December 1997. We evaluated the endoscopic and histological changes of gastric adenoma cases for≧3 years and analyzed the relationship between endoscopic and histological changes and clinicopathological factors, including follow-up periods, age, gender, serum pepsinogen level, serum H. pylori antibody level, lesion size and location, and phenotypic expression, using univariate analysis.

 Result : The total mean follow-up period was 91.9 months. Twelve lesions(44.4%)were not visible by endoscopy, and seven lesions(25.9%)disappeared in both endoscopy and histological examination. The mean period of endoscopic disappearance was 21.8 months after H. pylori eradication therapy. Fourteen(51.9%)lesions remained unchanged by endoscopy. Of these, six(22.2%)were diagnosed as intramucosal cancer at follow-up and were endoscopically treated. Univariate analysis revealed that gender(p=0.009), lesion size(p=0.025), and serum pepsinogen II level(p=0.0041)before H. pylori eradication therapy were significantly associated with the disappearance of lesions, both endoscopically and histologically.

 Conclusions : H. pylori eradication therapy may contribute to the improvement or disappearance of gastric adenoma. Therefore, H. pylori eradication therapy could be the initial therapy for gastric adenoma.


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

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