Published in:
19-10-2023 | Helicobacter Pylori | Original Article—Alimentary Tract
Clinicopathologic differences of gastric neoplasms between Helicobacter pylori-infected and -naïve patients: a multicenter retrospective analysis
Authors:
Satoshi Kotani, Kotaro Shibagaki, Noriyuki Hirahara, Nobuaki Hasegawa, Ryo Tanabe, Yuri Ebisutani, Saya Nonomura, Kenichi Kishimoto, Yasuhide Kodama, Yusuke Takahashi, Masatoshi Kataoka, Akihiko Oka, Nobuhiko Fukuba, Yoshiyuki Mishima, Naoki Oshima, Kousaku Kawashima, Norihisa Ishimura, Asuka Araki, Kyuichi Kadota, Ayako Itawaki, Makoto Nagasaki, Yoichi Miyaoka, Hideyuki Onuma, Shunji Ishihara
Published in:
Journal of Gastroenterology
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Issue 1/2024
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Abstract
Background
The incidence of gastric neoplasms in Helicobacter pylori (Hp)-naïve patients has recently increased due to a remarkable decrease in the Hp-infected population in Japan. We investigated the clinicopathologic differences between Hp-infected gastric neoplasms (HpIGNs) and Hp-naïve gastric neoplasms (HpNGNs) that have not been fully elucidated so far.
Methods
This retrospective multicenter study investigated 966 consecutive patients with 1131 gastric dysplasia or cancers who underwent endoscopic or surgical treatment for the recent decade. Clinicopathologic features were compared between HpIGN and HpNGN cases.
Results
One thousand and sixty-eight HpIGNs in 916 patients included 877 differentiated types and 191 undifferentiated types. Sixty-three HpNGNs in 50 patients included 57 differentiated types (35 foveolar types, 15 intestinal types, 6 fundic-gland types, and 1 other differentiated type) and 6 undifferentiated types. HpNGNs occurred in younger (59.5 vs. 71.8 years, p < 0.05) and female patients (40.0% vs. 26.5%, p < 0.05), were found more frequently in the proximal compartment (p < 0.05), and had smaller size (median 4.0 vs. 20.0 mm, p < 0.05). Histologically, HpNGNs and HpIGNs both primarily consisted of differentiated type (90.5% vs. 82.1%, p = 0.089) and HpNGNs showed lower prevalence of invasive cancer (11.1% vs. 37.6%, p < 0.05) and lymphovascular invasion (1.6% vs. 31.6%, p < 0.05). Nearly all HpNGNs (62/63, 98.4%) were diagnosed in early pathological stage, while 16.1% (172/1068) of HpIGNs were diagnosed in advanced stage (p < 0.05).
Conclusions
HpNGNs is recently on the increase but shows lower malignant nature regardless of histologic type than HpIGN. Endoscopic gastric cancer screening will be reviewed via cost effectiveness for Hp-naïve individuals in future.