Endoscopic and Immunohistochemical Characteristics of Gastric Cancer with versus without Helicobacter Pylori Eradication

Digestion. 2018;97(4):288-297. doi: 10.1159/000485504. Epub 2018 Mar 7.

Abstract

Background/aims: The rate of gastric cancer (GC) after Helicobacter pylori eradication has gradually increased; therefore, we investigate the clinicopathological features of GC following eradication in comparison with those of GC with H. pylori infection.

Methods: This study included 50 subjects with GC after eradication (GCE) and 151 patients with GC with H. pylori infection (GCI). Clinicopathological factors were assessed. The manifestation of GC was further evaluated using immunohistochemical analysis and in situ hybridization.

Results: Macroscopic analysis revealed a significantly higher ratio of depressed type /elevated type in the GCE compared with the GCI (30/19 vs. 61/77, p = 0.041). The gastric phenotype was more common in the GCE compared with the GCI, and the proportion of CDX2-positive cases was lower in the GCE (8 out of 18; 44.4%) compared with the GCI (18 out of 19; 94.7%; p = 0.00082). Ki-67 labeling index was significantly lower in the GCE (32.03 ± 22.15) compared with the GCI (79.20 ± 14.87, p < 0.0001). No patient in the GCE showed evidence of Epstein-Barr virus infection.

Conclusion: The clinicopathological characteristics of GC following H. pylori eradication differ from those of GC in patients with H. pylori infection in terms of morphology, mucin phenotype, and proliferation rate.

Keywords: Epstein-Barr virus; Eradication; Gastric cancer; Helicobacter pylori; Ki-67.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • CDX2 Transcription Factor / metabolism
  • Epstein-Barr Virus Infections / diagnosis
  • Epstein-Barr Virus Infections / virology
  • Female
  • Gastroscopy
  • Helicobacter Infections / diagnostic imaging*
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / drug effects*
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization
  • Ki-67 Antigen / analysis
  • Male
  • Middle Aged
  • Stomach / diagnostic imaging
  • Stomach / microbiology
  • Stomach / pathology
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / microbiology
  • Stomach Neoplasms / pathology

Substances

  • CDX2 Transcription Factor
  • CDX2 protein, human
  • Ki-67 Antigen