Abstract
A 67-year-old woman was admitted to our hospital for further examination and for treatment of gastric neoplasia located on the posterior wall of the antrum of the stomach, as revealed by screening esophagogastroduodenoscopy. The patient had no history of Helicobacter pylori (H. pylori) eradication. Her serum H. pylori antibody and urea breath test results were negative, histopathological findings revealed no H. pylori bacteria, and endoscopic findings revealed no chronic gastritis. We performed endoscopic submucosal dissection (ESD). Histological examination of the resected tissues revealed the tumor to be composed of a well-differentiated tubular adenocarcinoma with a tubular-type adenoma confined to the mucosa. This adenocarcinoma exhibited immunohistochemical expression of CD10, MUC2, and Cdx2, but not MUC5AC or MUC6. This is an extremely rare case of H. pylori infection-negative, intestinal-type, differentiated gastric adenocarcinoma revealed by detailed immunohistochemical examination that was treated with ESD. The patient has had no recurrence of adenocarcinoma after ESD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Huang JQ, Sridhar S, Chen Y, et al. Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer. Gastroenterology. 1988;114:1169–79.
Schistosomes, liver flukes and Helicobacter pylori. IARC Working Group on the Evaluation of Carcinogenic Risks to Human. Lyon, 7–14 June 1994. IARC Monogrval Eval Carcinog Risks Hum. 1994;61:1–241.
Matsushita T, Yamada N, Kato S, et al. Helicobacter pylori infection, mucosal atrophy and intestinal metaplasia in Asian populations: a comparative study in age-, gender-, and endoscopic diagnosis-matched subjects. Helicobacter. 2003;8:29–35.
Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:829–32.
Kato S, Matsukura N, Tsukada K, et al. Helicobacter pylori infection-negative gastric cancer in Japanese hospital patients: incidence and pathological characteristics. Cancer Sci. 2007;98:790–4.
Kakinoki R, Kushima R, Matsubara A, et al. Revaluation of histogenesis of gastric carcinomas: a comparative histopathological study between Helicobacter pylori-negative and H.pylori-positive cases. Dig Dis Sci. 2009;54:614–20.
Ueyama H, Yao T, Nakashima Y, et al. Gastric adenocarcinoma of fundic gland type (chief cell predominant type): proposal for a new entity of gastric adenocarcinoma. Am J Surg Pathol. 2010;34:609–19.
Matsuo T, Ito M, Takata S, et al. Low prevalence of Helicobacter pylori-negative gastric cancer among Japanese. Helicobacter. 2011;16:415–9.
Ono S, Kato M, Suzuki M, et al. Frequency of Helicobacter pylori-negative gastric cancer and gastric mucosal atrophy in a Japanese endoscopic submucosal dissection series including histological, endoscopic and serological atrophy. Digestion. 2012;86:59–65.
Yoon H, Kim N, Lee HS, et al. Helicobacter pylori-negative gastric cancer in South Korea: incidence and clinicopathologic characteristics. Helicobacter. 2011;16:382–8.
Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49.
Iriguchi Y, Oda J, Mizutani M, et al. Helicobacter pylori-negative advanced gastric cardia cancer detected with stomach X-ray examination, report of a case. Stoma Intest. 2014;49:931–8.
Konno N, Ishihata R, Takasumi M, et al. A case of Helicobacter pylori-negative differentiated-type gastric carcinoma with a gastric mucin phenotype treated by ESD. Gastroenterol Endsc. 2013;55:3095–101.
Ozaki Y, Suto H, Nosaka T, et al. A case of Helicobacter pylori-negative intramucosal well-differentiated gastric adenocarcinoma with intestinal phenotype. Clin J Gastroenterol. 2015;8:18–21.
Yagi K, Nakamura A, Sekine A. Characteristic endoscopic and magnified endoscopic findings in the normal stomach without Helicobacter pylori infection. J Gastroenterol Hepatol. 2002;17:39–45.
Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy. 2009;41:462–7.
Maki S, Yao K, Nagahama T, et al. Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions. Gastric Cancer. 2013;16:140–6.
Marrelli D, Pedrazzani C, Berardi A, et al. Negative Helicobacter pylori status is associated with poor prognosis with gastric cancer. Cancer. 2009;115:2071–80.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest:
Satoshi Kotani, Youichi Miyaoka, Aya Fujiwara, Kousuke Tsukano, Sayaka Ogawa, Satoshi Yamanouchi, Ryusaku Kusunoki, Hirofumi Fujishiro, Naruaki Kohge, Hideyuki Ohnuma, and Yoshikazu Kinoshita declare that they have no conflict of interest.
Human Rights:
All procedures were performed in accordance with the ethical standards set forth in the 1694 Declaration of Helsinki and its later amendments.
Informed Consent:
Informed consent was obtained from the patient for inclusion in the study.
Rights and permissions
About this article
Cite this article
Kotani, S., Miyaoka, Y., Fujiwara, A. et al. Intestinal-type gastric adenocarcinoma without Helicobacter pylori infection successfully treated with endoscopic submucosal dissection. Clin J Gastroenterol 9, 228–232 (2016). https://doi.org/10.1007/s12328-016-0654-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12328-016-0654-7