| Theme |
Carcinogenesis Based on H. pylori-associated Gastritis -- Is Cancer Control Possible by the Eradication ? |
| Title |
Alteration of Gastric Atrophy and Intestinal Metaplasia after H. pylori Eradication Therapy |
| Author |
Masaaki Kodama |
Department of Gastroenterolgy, Faculty of Medicine, Oita University |
| Author |
Kazunari Murakami |
Department of Gastroenterolgy, Faculty of Medicine, Oita University |
| Author |
Tadayoshi Okimoto |
Department of Gastroenterolgy, Faculty of Medicine, Oita University |
| Author |
Toshio Fujioka |
Department of Gastroenterolgy, Faculty of Medicine, Oita University |
| [ Summary ] |
Atrophic gastritis and intestinal metaplasia (IM) caused by Helicobacter pylori infection are considered to be premalignant lesions. Improvements in these conditions seen post-H. pylori eradication may be regarded as an important factor for gastric cancer prevention. Although many studies have reported the alteration of gastric mucosa after H. pylori eradication, most results do not support this conclusion. Some studies have shown improvements in atrophy and/or IM after H. pylori eradication. However, others showed no improvement. Recently, two metaanalysis studies showed significant improvement in atrophy (one study showed improvement in both the corpus and the antrum, and the other showed improvement in the corpus but not the antrum). Improvements in IM were not exhibited in both the corpus and antrum. However, one reason conclusions are different is considered to be that the observation period after eradication was short. Most studies observed patients for less than 2 years. The other reason is considered to be that most studies examined only 2 points in the gastric mucosa for histological analysis. Further examination with greater numbers of subjects and with longer follow up periods are required to clarify the mechanisms of gastric injury and improvements in gastric mucosa. Atrophy and IM after H. pylori eradication should be paid particular attention. Improvement in gastric atrophy and IM may reduce the risk of gastric cancer occurrence after H. pylori eradication. |