Re-evaluation of Histogenesis of Gastric Carcinomas: A Comparative Histopathological Study Between Helicobacter pylori-Negative and H. pylori-Positive Cases

• Published in: Digestive diseases and sciences 2009-03, Vol.54 (3), p.614-620
• Main Authors: Kakinoki, Rie, Kushima, Ryoji, Matsubara, Akiko, Saito, Yasuharu, Okabe, Hidetoshi, Fujiyama, Yoshihide, Hattori, Takanori
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biochemistry; Biological and medical sciences; Carcinoma - microbiology; Carcinoma - pathology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastric Mucins - analysis; Gastritis - pathology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroscopy; Helicobacter; Helicobacter Infections - microbiology; Helicobacter Infections - pathology; Helicobacter pylori - isolation & purification; Hepatology; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Medicine; Medicine & Public Health; Metaplasia; Middle Aged; Oncology; Original Article; Phenotype; Stomach - pathology; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Transplant Surgery; Tumors; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-008-0389-5

We histopathologically re-evaluated the histogenesis of gastric carcinomas from comparative studies between Helicobacter pylori-positive and H. pylori-negative cases using the gastritis score from the Updated Sydney System. The incidence of H. pylori-negative gastric carcinomas was 3.11% (12/386); they are likely to develop in the fundic gland mucosa, and show a gastric phenotype by mucin immunohistochemistry. Even in cases of completely gastric and predominantly gastric phenotypes, CDX2 protein was expressed in most cases (90.9% of pT1 and 100% of pT2-3), indicating a possibility that intestinalization of carcinoma cells occurs independently of the background mucosa. Regarding the degree of gastritis of background mucosa surrounding 143 H. pylori-positive differentiated-type adenocarcinomas, the mean score ranged from 1.497 to 1.713. Our data support the hypothesis that intestinal metaplasia is not a precancerous but a paracancerous lesion, and most gastric adenocarcinomas develop in mildly to moderately atrophic mucosa with H. pylori-infection, i.e., ongoing atrophy.