| Theme |
Best Available Managements of Helicobacter pylori Gastritis |
| Title |
Histopathological Changes in Gastric Mucosa post Helicobacter pylori Eradication |
| Author |
Tetsuya Tsukamoto |
Department of Diagnostic Pathology I, Fujita Health University School of Medicine |
| Author |
Yuka Kiriyama |
Department of Diagnostic Pathology I, Fujita Health University School of Medicine |
| Author |
Tomoyuki Shibata |
Department of Gastroenterology, Fujita Health University School of Medicine |
| [ Summary ] |
The extent of gastric mucosal atrophy and intestinal metaplasia before eradication of Helicobacter pylori (H. pylori) is an important factor for the prevention of gastric cancer. H. pylori infection induces hyperplasia of the surface foveolar epithelial cells and expansion of the proliferative zone as observed in human specimens. Similarly, in Mongolian gerbils, mucosal hyperplasia and submucosal expansion of heterotopic proliferative glands occur, mimicking some populations of human cases. Eradication of the bacterium successfully normalizes these hyperplastic reactions in both species. On the other hand, it is not feasible to evaluate the degree of atrophy of proper glands (fundic and pyloric glands) and intestinal metaplasia before as well as after eradication through examination of biopsy specimens. This presents an obstacle to making effective decisions on sterilization. The inhibitory effects on gastric carcinogenesis from sterilization of H. pylori are more effective in milder cases of gastritis in humans. Earlier eradication has also been revealed to be more effective in gerbils for the prevention of gastric cancer. It may become increasingly necessary to accurately evaluate the effectiveness of eradication to perform eradication therapy appropriately. |