| Theme |
Carcinogenesis Based on H. pylori-associated Gastritis -- Is Cancer Control Possible by the Eradication ? |
| Title |
Causative Factors of Stomach Carcinogenesis after Eradication Therapy for H. pylori Infection |
| Author |
Shunji Kato |
Department of Surgery, Nippon Medical School |
| Author |
Norio Matsukura |
Department of Surgery, Nippon Medical School |
| Author |
Itsuo Fujita |
Department of Surgery, Nippon Medical School |
| Author |
Hiroyuki Onodera |
Department of Surgery, Nippon Medical School |
| Author |
Nobuyuki Sakurazawa |
Department of Surgery, Nippon Medical School |
| Author |
Nobutoshi Hagiwara |
Department of Surgery, Nippon Medical School |
| Author |
Yoshikazu Kanazawa |
Department of Surgery, Nippon Medical School |
| Author |
Tsutomu Nomura |
Department of Surgery, Nippon Medical School |
| Author |
Eiji Uchida |
Department of Surgery, Nippon Medical School |
| [ Summary ] |
H. pylori infection is a definite carcinogen leading to stomach carcinogenesis. However, clinically, new or secondary stomach cancers may develop after eradication of H. pylori infection. It is well known that reflux of bile and pancreatic juices, as well as neutralization of pH levels in the stomach, may contribute to production of nitroso-carcinogenic compounds. These compounds may be linked to other carcinogenic factors. We calculated cumulative regenerative morbidity rates in relation to stomach cancer after mucosal resection treatment including endoscopic or local resection. Those rates were higher than those for distal gastrostomy with Billroth II, or Billroth I re-construction procedures, 14.3 %, 7.5 %, 1.9 % respectively. Higher levels of inflammation in the stomach, evaluated from scores derived from the degree of inflammation observed with moderate to severe involvement in the upper segment, without H. pylori infection after the eradication therapy or natural elimination of H. pylori by bile reflux in the mucosa. By comparison, no or only slight inflammation, was found to be more of a risk factor for the development of stomach cancer. It was also seen as a supportive biomarker for the selection of high risk stomach cancer groups. A clinical case for new developments in stomach cancer prediction by this method is exhibited. |