Document Detail


Sustained epithelial proliferation in a functionally irreversible fundic mucosa after Helicobacter pylori eradication.
MedLine Citation:
PMID:  19159072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We recently reported the expansion of the acid-secreting mucosa following Helicobacter pylori eradication with Congo red chromoendoscopy for a short-term follow-up of up to 7 months. We aimed to extend the observation period and to clarify the characteristic features of acid-secreting and non-acid-secreting mucosa. METHODS: In 24 H. pylori-positive patients with fundic atrophy, Congo red chromoendoscopy was performed prior to, 1 month, 7 months, and finally more than 2 years after the eradication. The areas of the acid-secreting mucosa were evaluated semiquantitatively. Two gastric biopsy specimens were taken from the acid-secreting and non-acid-secreting areas at the final chromoendoscopy and were subjected to histologic evaluation and immunohistochemistry for Ki-67 as a proliferation index. RESULTS: After a gradual increase in acid-secreting areas for up to 7 months after eradication, they further increased in 79% subjects between 7 months and the final observation at a mean follow-up of 62 months. However, there still existed non-acid-secreting mucosa in the fundic area in all subjects, indicating that the expansion of acid-secreting mucosa remained partial. Compared with the neighboring acid-secreting area, the non-acid-secreting area was characterized histologically by higher degrees of residual inflammation, mucosal atrophy, and intestinal metaplasia, and by sustained hyperproliferation as well. CONCLUSIONS: Functionally irreversible (non-acid-secreting) gastric mucosa after eradication was associated with extensive intestinal metaplasia and sustained hyperproliferation, suggesting that such mucosa still possesses malignant potential. Congo red chromoendoscopy may be useful for estimating the risk of subsequent development of gastric cancer following successful H. pylori eradication by determining the distribution of functionally irreversible mucosa.
Authors:
Katsunori Iijima; Tomoyuki Koike; Hitoshi Sekine; Yasuhiko Abe; Kiyotaka Asanuma; Nobuyuki Ara; Kaname Uno; Akira Imatani; Shuichi Ohara; Tooru Shimosegawa
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-01-22
Journal Detail:
Title:  Journal of gastroenterology     Volume:  44     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-01-22     Completed Date:  2009-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  47-55     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan.
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MeSH Terms
Descriptor/Qualifier:
Cell Proliferation
Coloring Agents / diagnostic use*
Congo Red / diagnostic use*
Epithelial Cells / metabolism
Female
Follow-Up Studies
Gastric Acid / secretion
Gastric Fundus / metabolism,  microbiology,  pathology
Gastric Mucosa / metabolism*,  microbiology,  pathology
Gastroscopy / methods*
Helicobacter Infections / microbiology,  pathology,  therapy
Helicobacter pylori / isolation & purification
Humans
Male
Middle Aged
Prospective Studies
Recovery of Function
Time Factors
Chemical
Reg. No./Substance:
0/Coloring Agents; 573-58-0/Congo Red

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