Clinical outcomes of metachronous recurrence of gastric epithelial neoplasia based on Helicobacter pylori infection status and microsatellite stability
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Background/Aims: Helicobacter pylori eradication may prevent the recurrence of gastric epithelial neoplasia after endoscopic treatment. However, H. pylori eradication therapy is unlikely to prevent gastric cancer. This study determined the longterm results and clinical outcomes of patients with gastric epithelial neoplasia based on H. pylori infection status and microsatellite stability (MSS). Methods: Patients diagnosed with gastric epithelial neoplasia who underwent an endoscopic mucosal resection or submucosal dissection between 2004 and 2010 were included in this retrospective study. During the follow-up period (range, 4 to 14 years), disease recurrence was monitored, and tissue examinations were conducted for seven sets of microsatellite loci initially linked to the tumour suppressor gene locus. When H. pylori infection was identified, patients underwent eradication therapy. Results: The patients (n = 120) were divided into three groups: H. pylori-negative with MSS, H. pylori-positive with MSS, and microsatellite instability (MSI). After H. pylori eradication, the rate of metachronous recurrence was significantly different in the MSI (28.2%) and MSS groups (3.7%, p < 0.01). The mean duration of recurrence was 77 months (range, 24 to 139) in the MSI group. There was no recurrence after eradication therapy in patients who were positive for H. pylori in the MSS group. Conclusion: H. pylori eradication could help prevent gastric cancer recurrence in patients with stable microsatellite loci. Careful, long-term monitoring is required in patients with unstable microsatellite loci.
Abstract
Background/Aims: Helicobacter pylori eradication may prevent the recurrence of gastric epithelial neoplasia after endoscopic treatment. However, H. pylori eradication therapy is unlikely to prevent gastric cancer. This study determined the longterm results and clinical outcomes of patients with gastric epithelial neoplasia based on H. pylori infection status and microsatellite stability (MSS). Methods: Patients diagnosed with gastric epithelial neoplasia who underwent an endoscopic mucosal resection or submucosal dissection between 2004 and 2010 were included in this retrospective study. During the follow-up period (range, 4 to 14 years), disease recurrence was monitored, and tissue examinations were conducted for seven sets of microsatellite loci initially linked to the tumour suppressor gene locus. When H. pylori infection was identified, patients underwent eradication therapy. Results: The patients (n = 120) were divided into three groups: H. pylori-negative with MSS, H. pylori-positive with MSS, and microsatellite instability (MSI). After H. pylori eradication, the rate of metachronous recurrence was significantly different in the MSI (28.2%) and MSS groups (3.7%, p < 0.01). The mean duration of recurrence was 77 months (range, 24 to 139) in the MSI group. There was no recurrence after eradication therapy in patients who were positive for H. pylori in the MSS group. Conclusion: H. pylori eradication could help prevent gastric cancer recurrence in patients with stable microsatellite loci. Careful, long-term monitoring is required in patients with unstable microsatellite loci.
참고문헌 (33)
- Leontiadis GI, "Helicobacter pylori eradication : gastric cancer prevention", BMJ Clin Evid, 2015, pp.0406~ (2015)
- Lee YC, "Association between Helicobacter pylori eradication and gastric cancer incidence : a systematic review and meta-analysis", Gastroenterology, 150, pp.1113~1124 (2016)
- Choi IJ, "Helicobacter pylori therapy for the prevention of metachronous gastric cancer", N Engl J Med, 378, pp.1085~1095 (2018)
- Choi JM, "Effects of Helicobacter pylori eradication for metachronous gastric cancer prevention : a randomized controlled trial", Gastrointest Endosc, 88, pp.475~485 (2018)
- Wong BC, "Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China : a randomized controlled trial", JAMA, 291, pp.187~194 (2004)
- Choi J, "Eradication of Helicobacter pylori after endoscopic resection of gastric tumors does not reduce incidence of metachronous gastric carcinoma", Clin Gastroenterol Hepatol, 12, pp.793~800 (2014)
- Jiro Watari, "Preventing Metachronous Gastric Cancer after the Endoscopic Resection of Gastric Epithelial Neoplasia: Roles of Helicobacter pylori Eradication and Aspirin", Gut and Liver, 14(3), pp.281~290 (2020), 거트앤리버 소화기연관학회협의회[DOI]
- Van Cutsem E, "Gastric cancer", Lancet, 388, pp.2654~2664 (2016)
- Leung WK, "Microsatellite instability in gastric intestinal metaplasia in patients with and without gastric cancer", Am J Pathol, 156, pp.537~543 (2000)
- Velho S, "Causes and consequences of microsatellite instability in gastric carcinogenesis", World J Gastroenterol, 20, pp.16433~16442 (2014)
- Lee HS, "Distinct clinical features and outcomes of gastric cancers with microsatellite instability", Mod Pathol, 15, pp.632~640 (2002)
- Stolte M, "The new Vienna classification of epithelial neoplasia of the gastrointestinal tract : advantages and disadvantages", Virchows Arch, 442, pp.99~106 (2003)
- 정우철, "Genetic Instability in Gastric Epithelial Neoplasias Categorized by the Revised Vienna Classification", Gut and Liver, 4(2), pp.179~185 (2010), 거트앤리버 소화기연관학회협의회
- Nishida T, "Endoscopic surveillance strategy after endoscopic resection for early gastric cancer", World J Gastrointest Pathophysiol, 5, pp.100~106 (2014)
- Hyun Jik Lee, "Characteristics of Synchronous and Metachronous Multiple Gastric Tumors after Endoscopic Submucosal Dissection of Early Gastric Neoplasm", Clinical Endoscopy, 51(3), pp.266~273 (2018), 대한소화기내시경학회
- Fearon ER, "A genetic basis for the multi-step pathway of colorectal tumorigenesis", Princess Takamatsu Symp, 22, pp.37~48 (1991)
- Correa P, "The gastric precancerous cascade", J Dig Dis, 13, pp.2~9 (2012)
- Kong YJ, "Histological changes of gastric mucosa after Helicobacter pylori eradication : a systematic review and meta-analysis", World J Gastroenterol, 20, pp.5903~5911 (2014)
- Jung S, "Preventing metachronous gastric lesions after endoscopic submucosal dissection through Helicobacter pylori eradication", J Gastroenterol Hepatol, 30, pp.75~81 (2015)
- Nakata R, "Successful eradication of Helicobacter pylori could prevent metachronous gastric cancer : a propensity matching analysis", Digestion, 102, pp.236~245 (2021)
- Xiao S, "Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer : a systematic review and meta-analysis", J Gastroenterol, 54, pp.226~237 (2019)
- Seung Jun Han, "Long-Term Effects of Helicobacter pylori Eradication on Metachronous Gastric Cancer Development", Gut and Liver, 12(2), pp.133~141 (2018), 거트앤리버 소화기연관학회협의회
- 최아름, "Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of a Gastric Neoplasm", Korean Journal of Helicobacter Upper Gastrointestinal Research, 19(3), pp.184~192 (2019), 대한상부위장관ㆍ헬리코박터학회[DOI]
- Kim SB, "Association between Helicobacter pylori status and metachronous gastric cancer after endoscopic resection", World J Gastroenterol, 22, pp.9794~9802 (2016)
- Park WY, "Occurrence of metachronous or synchronous lesions after endoscopic treatment of gastric epithelia dysplasia-impact of histologic features of background mucosa", Pathol Res Pract, 214, pp.95~99 (2018)
- 정창수, "Risk Factors for Metachronous Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer", Journal of Korean Medical Science, 32(3), pp.421~426 (2017), 대한의학회
- Lim JH, "Risk factors for synchronous or metachronous tumor development after endoscopic resection of gastric neoplasms", Gastric Cancer, 18, pp.817~823 (2015)
- Shichijo S, "Histologic intestinal metaplasia and endoscopic atrophy are predictors of gastric cancer development after Helicobacter pylori eradication", Gastrointest Endosc, 84, pp.618~624 (2016)
- Malfertheiner P, "Gastric atrophy reversible or irreversible after Helicobacter pylori eradication : an open question", Digestion, 83, pp.250~252 (2011)
- Venerito M, "Preneoplastic conditions in the stomach : always a point of no return?", Dig Dis, 33, pp.5~10 (2015)
- Wright NA, "Helicobacter pylori", pp.325~335 (1998), Springer
- Murphy KM, "Comparison of the microsatellite instability analysis system and the Bethesda panel for the determination of microsatellite instability in colorectal cancers", J Mol Diagn, 8, pp.305~311 (2006)
- Verma R, "Microsatellite instability in mismatch repair and tumor suppressor genes and their expression profiling provide important targets for the development of biomarkers in gastric cancer", Gene, 710, pp.48~58 (2019)