| Theme |
How to Diagnose Gastric Diseases in Patients without Helicobacter pylori Infection |
| Title |
Gastric Pathology in Helicobacter pylori Infected or Uninfected Status |
| Author |
Tetsuya Tsukamoto |
Department of Diagnostic Pathology, Fujita Health University School of Medicine |
| Author |
Asako Okabe |
Department of Diagnostic Pathology, Fujita Health University School of Medicine |
| Author |
Sayumi Tahara |
Department of Diagnostic Pathology, Fujita Health University School of Medicine |
| Author |
Mitsuru Nakagawa |
Department of Diagnostic Pathology, Fujita Health University School of Medicine |
| Author |
Yuka Kiriyama |
Department of Diagnostic Pathology, Fujita Health University School of Medicine / Department of Diagnostic Pathology, Narita Memorial Hospital |
| Author |
Makoto Kuroda |
Department of Diagnostic Pathology, Fujita Health University School of Medicine |
| [ Summary ] |
Gastric cancer remains a significant public health issue despite its declining prevalence. The bacterium Helicobacter pylori (H. pylori) is known to colonize the human stomach and induce chronic atrophic gastritis, intestinal metaplasia, and/or gastric cancer. Eradication therapy for H. pylori is aimed at preventing associated lesions ; however, it is not always effective in patients with intestinal metaplasia or dysplasia. As H. pylori eradication therapy is the predominant treatment method of its kind, it is indispensable to understand the patient's infection status and the extent of chronic atrophic gastritis and intestinal metaplasia to speculate the risk of developing cancer. In uninfected individuals, the gastric ducts are arranged in an orderly fashion, while in the currently infected individuals, H. pylori is observed in surface mucus of the regenerating foveolar epithelium accompanied with atrophy of the proper glands and the development of intestinal metaplasia. Neutrophil infiltration and lymphoid follicle formation are observed in the interstitium. Following eradication of the bacteria, the gland epithelial proliferation converges and the edematous stroma remains. Intestinal metaplasia, however, persists for a long time. Accurate pathological diagnosis, consistent with endoscopic findings, would be beneficial in determining the appropriate treatment and for risk assessment of the patients. |