Neutrophil Infiltration and the Distribution of Intestinal Metaplasia Is Associated with Metachronous Gastric Cancer following Endoscopic Submucosal DissectionReport as inadecuate




Neutrophil Infiltration and the Distribution of Intestinal Metaplasia Is Associated with Metachronous Gastric Cancer following Endoscopic Submucosal Dissection - Download this document for free, or read online. Document in PDF available to download.

Canadian Journal of Gastroenterology and Hepatology - Volume 29 2015, Issue 6, Pages 321-325

Original Article

Department of Gastroenterology, Kyoundo Hospital, Japan

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan

Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Japan

Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan

Received 4 March 2015; Accepted 7 March 2015

Copyright © 2015 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC http:-creativecommons.org-licenses-by-nc-4.0-, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.

Abstract

BACKGROUND: Endoscopic submucosal dissection ESD of early gastric cancer is a minimally invasive procedure. However, the risk for metachronous cancers after successful cancer treatment remains high and the risk factors for metachronous cancers have not been elucidated.

OBJECTIVE: To evaluate the risk factors for metachronous gastric cancers after ESD with a long-term follow-up.

METHODS: A total of 155 consecutive patients 119 men, 36 women, mean age 68.9 years were treated with ESD between September 2000 and September 2009. Biopsy specimens were obtained from the greater curvature of the antrum and middle corpus to evaluate gastric mucosal status, including Helicobacter pylori, intestinal metaplasia IM and neutrophil infiltration NI before ESD. Follow-up endoscopy after ESD was scheduled at two and six months, one year and annually thereafter. H pylori eradication was recommended when possible.

RESULTS: The median follow-up period was 4.2 years. Metachronous gastric cancers were found in 23 of 155 patients 3.5% per year. No local recurrences were observed. The cumulative incidence of metachronous gastric cancer was significantly high in IM and NI in the corpus P=0.0093 and P=0.0025, respectively log-rank test. The ORs for IM and NI in the corpus were 2.65 and 3.06, respectively, according to the Cox proportional hazards model P=0.024 and P=0.0091, respectively.

CONCLUSIONS: The presence of IM and NI in the corpus was closely related to the development of metachronous gastric cancer after ESD.





Author: Takafumi Sugimoto, Yutaka Yamaji, Kosuke Sakitani, Yoshihiro Isomura, Shuntaro Yoshida, Atsuo Yamada, Yoshihiro Hirata, Keiji Ogu

Source: https://www.hindawi.com/



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