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Characteristics of gastric cancer according to H elicobacter pylori infection status
Author(s) -
Kwak HeeWon,
Choi Il Ju,
Cho SooJeong,
Lee Jong Yeul,
Kim Chan Gyoo,
Kook MyeongCherl,
Ryu Keun Won,
Kim YoungWoo
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12605
Subject(s) - medicine , rapid urease test , intestinal metaplasia , gastroenterology , cancer , histology , serology , incidence (geometry) , helicobacter pylori , gastritis , pathology , immunology , antibody , physics , optics
Background and Aims The definition and incidence of gastric cancer ( GC ) without H elicobacter pylori ( H p) infection varies between studies. The aim of our study was to compare the characteristics of GC according to H p infection status. Methods We evaluated the presence of H p infection in 1833 GC patients with rapid urease tests, serology examinations, and histological evaluations. GC was classified as GC with current H p infection ( HpC ‐ GC ), GC with past H p infection ( HpP ‐ GC ), and GC not associated with H p infection ( HpN ‐ GC ). HpP ‐ GC was defined as GC without current infection but with a positive serology test, glandular atrophy, and/or intestinal metaplasia. HpN ‐ GC was defined as GC with negative H p test results and no histological changes. Results The numbers of HpC ‐ GC , HpP ‐ GC , and HpN ‐ GC were 1378 (75.2%), 412 (22.5%), and 43 (2.3%), respectively. Among GCs without current infection, 90.5% (412/455) were associated with HpP ‐ GC . HpP ‐ GCs were more common in older and male patients, had an increased incidence of synchronous cancer, and less frequently had a diffuse‐type histology than HpC ‐ GCs . HpN ‐ GCs were more common in younger, female patients; had a higher proportion of diffuse‐type cancers; and more frequently showed distant metastasis than HpP ‐ GCs . In the 40s, the proportion of HpP ‐ GCs with diffuse‐type histology (41.9%) was lower than that of HpC ‐ GCs (60.3%) ( P = 0.016). The difference was also significant in the 50s (29.1% vs 40.1%, respectively, P = 0.004). Conclusions Most GCs in K orea without current H p infection showed evidence of past H p infection. The proportion of GCs with diffuse‐type histology decreased in patients with past infection.