| 特集名 | 慢性胃炎を再考する | |
|---|---|---|
| 題名 | H. pylori未感染胃癌の発生部位別特徴 | |
| 発刊年月 | 2019年 12月 | |
| 著者 | 吉村 大輔 | 済生会福岡総合病院消化器内科 |
| 著者 | 吉村 理江 | 人間ドックセンターウェルネス |
| 著者 | 加藤 誠也 | 済生会福岡総合病院病理診断科 |
| 著者 | 北川 祐介 | 済生会福岡総合病院消化器内科 |
| 著者 | 中野 佳余子 | 済生会福岡総合病院消化器内科 |
| 著者 | 落合 利彰 | 済生会福岡総合病院消化器内科 |
| 【 要旨 】 | Helicobacter pylor (H. pylori)感染率の低下と未感染世代の検診年齢への到達を背景に，現在スクリーニング内視鏡では未感染胃が増えている．このポストピロリ時代の胃病変としてH. pylori未感染胃癌も今後相対的増加が予想される．自験例は噴門部癌ないし食道胃接合部腺癌，体上部を中心に胃底腺領域に局在した隆起型を主体とする胃型形質の低異型度腺癌（超高分化型腺癌），胃底腺と幽門腺の境界領域に局在する褪色平坦な印環細胞癌に大別され，腺領域ごとに好発する病変の形態や組織型に特徴があることが示唆された． | |
| Theme | Reconsideration of Gastritis | |
|---|---|---|
| Title | Characteristics of Gastric Cancers without Helicobacter pylori Infection and Association with the Background Mucosa | |
| Author | Daisuke Yoshimura | Division of Gastroenterology, Saiseikai Fukuoka General Hospital |
| Author | Rie Yoshimura | Medical Checkup Center Wellness |
| Author | Seiya Kato | Division of Pathology, Saiseikai Fukuoka General Hospital |
| Author | Yusuke Kitagawa | Division of Gastroenterology, Saiseikai Fukuoka General Hospital |
| Author | Kayoko Nakano | Division of Gastroenterology, Saiseikai Fukuoka General Hospital |
| Author | Toshiaki Ochiai | Division of Gastroenterology, Saiseikai Fukuoka General Hospital |
| [ Summary ] | Between April 2005 and December 2018, we retrospectively investigated cases of gastric cancer without Helicobacter pylor(HP) infection, and 61 patients who met the criteria for HP‒uninfected cases based on laboratory investigations, endoscopic and histopathological diagnosis were enrolled in the study. Interestingly, most patients were classified into three categories as follows: the first category included those with cancer of the gastric cardia or the gastroesophageal junction. The second category included patients with well‒differentiated adenocarcinoma, all of which were superficial cancers located in the fundic gland region. Histopathologically, the appearance and immunohistochemical phenotype resembled the foveolar epithelium, fundic glands, pseudopyloric glands, or a combination of these. The third category included signet‒ring cell carcinomas located in the transitional zone of the fundic and pyloric glands. Most carcinomas presented as flat whitish lesions restricted to the mucosa. Our study indicated that gastric cancer without HP infection can be classified into at least three distinct categories that are closely associated with the gastric region and background mucosa. |
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