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Biomarkers predicting development of metachronous gastric cancer after endoscopic resection: an analysis of molecular pathology of Helicobacter pylori eradication
Author(s) -
Watari Jiro,
Moriichi , Kentaro,
Tanabe , Hiroki,
Kashima Shin,
Nomura Yoshiki,
Fujiya Mikihiro,
Tomita Toshihiko,
Oshima Tadayuki,
Fukui Hirokazu,
Miwa Hiroto,
Das Kiron M.,
Kohgo Yutaka
Publication year - 2011
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.26275
Subject(s) - helicobacter pylori , gastroenterology , medicine , cancer , intestinal metaplasia , microsatellite instability , gastritis , pathology , biology , allele , biochemistry , microsatellite , gene
Metachronous gastric cancer (MGC) after endoscopic resection (ER) of gastric cancer still occurs to some degree even after Helicobacter pylori ( H. pylori ) treatment. We evaluated whether two biomarkers related to carcinogenesis expressed in intestinal metaplasia (IM) become predictors for MGC development after eradication. We performed a hospital‐based, case–control study of 75 patients, including 50 mucosal cancer patients who had undergone ER (Group DYS), and 25 age‐ and sex‐matched chronic gastritis patients for whom H. pylori had been successfully eradicated (control). Additionally, Group DYS patients were divided into two groups: 25 successfully H. pylori ‐eradicated (eradicated group) and 25 un‐eradicated patients (persistent group). All patients were followed for 1 year. We analyzed microsatellite instability (MSI) and immunoperoxidase assays using a monoclonal antibody for the colonic phenotype (Das‐1). Both MSI and Das‐1 reactivity in IM were significantly higher in Group DYS than in the control ( p < 0.05 and p < 0.01, respectively). MSI and Das‐1 reactivity were strong and independent predictors for gastric cancer (OR = 7.09, 95% CI 1.27–39.6, p = 0.03 for MSI and OR = 4.96, 95% CI 1.64–15.0, p = 0.005 for Das‐1 reactivity). The incidence of MSI tended to decrease in the eradicated group ( p = 0.07), but not in the persistent group. The Das‐1 immunoreactivity in IM also declined in both the eradicated group and the control. Interestingly, all MGCs after ER were positive for MSI or Das‐1 reactivity. MSI or Das‐1 reactivity in IM strongly predicts the development of MGC. Patients in whom these biomarkers persist after eradication may therefore have a high risk of developing MGC.