Clinical Gastroenterology Vol.27 No.3(3-3)

Theme Carcinogenesis Based on H. pylori-associated Gastritis -- Is Cancer Control Possible by the Eradication ?
Title Long-term Risk of Gastric Cancer after Successful Eradication of Helicobacter pylori
Publish Date 2012/03
Author Motowo Mizuno Department of Internal Medicine, Hiroshima City Hospital
Author Susumu Take Department of Internal Medicine, Fukuwatari Municipal Hospital
Author Kuniharu Ishiki Department of Internal Medicine, Nippon Kokan Fukuyama Hospital
Author Kazuhide Yamamoto Department of Medicine and Medical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
[ Summary ] We previously reported that eradication of Helicobacter pylori reduced the risk of developing gastric cancer in patients with peptic ulcer diseases and that eradication of H. pylori before the significant expansion of atrophy is most beneficial to prevent gastric cancer. In a further follow-up study, patients were followed for up to 14.1 years (a mean of 5.6 years). During the follow-up period, gastric cancer developed in 28 of the 1,674 patientsaslong as 13.7 years after cure of H. pylori infection. The risk of developing gastric cancer was 0.30 % per year. Histologically, 16 of the gastric cancers were of the intestinal-type and 12 of the diffuse-type. The risk of each cancer type was 0.17 % and 0.13 % per year, respectively. There was no significant inflammatory cell infiltration in the background gastric mucosa at the time the cancers were recognized. Thus, there is a risk of developing gastric cancer of both the intestinal and diffuse types even after cure of H. pylori infection and extinction of gastric inflammation. It is important to inform patients about the risk of gastric cancer after eradication therapy and offer them surveillance endoscopy.
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