Clinical Gastroenterology Vol.28 No.8(7-4)

Theme Determination of Gastric Cancer Risk -- Current Conditions and Issues
Title Medical Examinations to Evaluate Undifferentiated Gastric Cancer
Publish Date 2013/07
Author Mika Watanabe Wakayama Wellness Center / Second Department of Internal Medicine, Wakayama Medical University
Author Jun Kato Second Department of Internal Medicine, Wakayama Medical University
Author Shotaro Enomoto Wakayama Wellness Center / Second Department of Internal Medicine, Wakayama Medical University
Author Takeichi Yoshida Wakayama Wellness Center / Second Department of Internal Medicine, Wakayama Medical University
Author Hisanobu Deguchi Second Department of Internal Medicine, Wakayama Medical University
Author Masao Ichinose Second Department of Internal Medicine, Wakayama Medical University
[ Summary ] Following H. pylori infection, undifferentiated gastric cancer is known to occur at high rates in patients with active gastritis. This occurs in the gastric body of individuals who exhibit mild atrophy and severe inflammation. This differs from the conventional progression proposed by Correa et al. in which atrophic gastritis progreses to intestinal metaplasia, dysplasia and then gastric cancer. By identifying a group with mild atrophic gastritis and severe inflammation using serum pepsinogen levels in individuals with H. pylori infection, and further identifying individuals with concurrent rugal hyperplastic gastritis-which reportedly offers an indicator of active gastritis in the gastric body endoscopic examination, reveal it is possible to identify a group at very high risk of undifferentiated gastric cancer. Observational study also suggests that the development of gastric cancer can be inhibited by H. pylori eradication therapy in this high-risk group.
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