Nagai K. · Hayashi Y. · Uema R. · Inoue T. · Kimura K. · Sakatani A. · Yoshii S. · Tsujii Y. · Shinzaki S. · Iijima H. · Takehara T.

Author affiliations

Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: September 14, 2021
Accepted: May 01, 2022
Published online: June 16, 2022

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Introduction: Magnifying endoscopy with narrow-band imaging (M-NBI) is useful for determining lateral demarcation of early gastric cancers; however, this is sometimes difficult. Features related to an unclear lateral demarcation remain unknown. We evaluated the clinical and histopathological features of early gastric cancers with unclear lateral demarcation on M-NBI. Methods: This single-center, retrospective, cohort study analyzed early gastric cancer treated by endoscopic submucosal dissection between January 2013 and August 2015. We evaluated the clinicopathological and immunohistochemical features using anti-p53, anti-Ki-67, anti-MUC5AC, anti-MUC6, anti-MUC2, and anti-CD10 antibody staining. We compared the lateral demarcation between the demarcation clear (DC) and the demarcation unclear (DU) lesions by using M-NBI. Results: A total of 224 differentiated adenocarcinomas (DU group: 18 lesions; DC group: 206 lesions) were analyzed. A history of successful Helicobacter pylori eradication was significantly more frequent in the DU group (p = 0.001). We examined the tissues of 72 lesions (DU group: 18 lesions, DC group: 54 lesions [randomly selected]) immunohistochemically. The nonneoplastic superficial epithelium was observed more frequently in the DU group as compared to in the DC group (p = 0.006). Additionally, compared to the DC group, the DU group showed a significantly higher expression of the gastric phenotype markers (p = 0.023) and had lower p53 scores (p < 0.001) and Ki-67 labeling indexes (p = 0.029). Multivariate analysis revealed the nonneoplastic superficial epithelium and a low p53 score as the significant independent variables associated with an unclear lateral demarcation on M-NBI. Conclusions: The nonneoplastic superficial epithelium and a low p53 score were associated with difficulties in determining the lateral demarcation in early gastric cancers on M-NBI.

© 2022 S. Karger AG, Basel

References Nagahama T, Yao K, Maki S, Yasaka M, Takaki Y, Matsui T, et al. Usefulness of magnifying endoscopy with narrow-band imaging for determining the horizontal extent of early gastric cancer when there is an unclear margin by chromoendoscopy (with video). Gastrointest Endosc. 2011;74(6):1259–67. Kiyotoki S, Nishikawa J, Satake M, Fukagawa Y, Shirai Y, Hamabe K, et al. Usefulness of magnifying endoscopy with narrow-band imaging for determining gastric tumor margin. J Gastroenterol Hepatol. 2010;25(10):1636–41. Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy. 2009;41(5):462–7. Yao K, Nagahama T, Matsui T, Iwashita A. Detection and characterization of early gastric cancer for curative endoscopic submucosal dissection. Dig Endosc. 2013;25(Suppl 1):44–54. Kakushima N, Ono H, Tanaka M, Takizawa K, Yamaguchi Y, Matsubayashi H. Factors related to lateral margin positivity for cancer in gastric specimens of endoscopic submucosal dissection. Dig Endosc. 2011;23(3):227–32. Asaka M, Kato M, Takahashi S, Fukuda Y, Sugiyama T, Ota H, et al. Guidelines for the management of Helicobacter pylori infection in Japan: 2009 revised edition. Helicobacter. 2010 Feb;15(1):1–20. Fukase K, Kato M, Kikuchi S, Inoue K, Uemura N, Okamoto S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet. 2008;372(9636):392–7. Yamamoto K, Kato M, Takahashi M, Haneda M, Shinada K, Nishida U, et al. Clinicopathological analysis of early-stage gastric cancers detected after successful eradication of Helicobacter pylori. Helicobacter. 2011;16(3):210–6. Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;1(3):87–97. Kobayashi M, Hashimoto S, Mizuno K, Takeuchi M, Sato Y, Watanabe G, et al. Therapeutic or spontaneous Helicobacter pylori eradication can obscure magnifying narrow-band imaging of gastric tumors. Endosc Int Open. 2016;4(6):E665–72. Japanese Gastric Cancer Association. Gastric cancer treatment guideline. 4th ed. Tokyo: Kanahara; 2014. Vol. 20; p. 23. (in Japanese). Saito Y, Uraoka T, Yamaguchi Y, Hotta K, Sakamoto N, Ikematsu H, et al. A prospective, multicenter study of 1,111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc. 2010;72(6):1217–25. Kizu T, Yoshida Y, Furuta K, Ogura S, Egawa M, Chatani N, et al. Loss of Gab1 adaptor protein in hepatocytes aggravates experimental liver fibrosis in mice. Am J Physiol Gastrointest Liver Physiol. 2015;308(7):G613–24. Teh M, Tan KB, Seet BL, Yeoh KG. Study of p53 immunostaining in the gastric epithelium of cagA-positive and cagA-negative Helicobacter pylori gastritis. Cancer. 2002;95(3):499–505. Goto T, Nguyen BP, Nakano M, Ehara H, Yamamoto N, Deguchi T. Utility of Bcl-2, P53, Ki-67, and caveolin-1 immunostaining in the prediction of biochemical failure after radical prostatectomy in a Japanese population. Urology. 2008;72(1):167–71. Sasaki A, Kitadai Y, Ito M, Tanaka S, Yoshihara M, Haruma K, et al. Mucin phenotype and background mucosa of intramucosal differentiated-type adenocarcinoma of the stomach. Oncology. 2004;66(5):379–87. Yao K, Doyama H, Gotoda T, Ishikawa H, Nagahama T, Yokoi C, et al. Diagnostic performance and limitations of magnifying narrow-band imaging in screening endoscopy of early gastric cancer: a prospective multicenter feasibility study. Gastric Cancer. 2014;17(4):669–79. Akazawa Y, Ueyama H, Yao T, Komori H, Takeda T, Matsumoto K, et al. Usefulness of demarcation of differentiated-type early gastric cancers after Helicobacter pylori eradication by magnifying endoscopy with narrow-band imaging. Digestion. 2018;98(3):175–84. Ito M, Tanaka S, Takata S, Oka S, Imagawa S, Ueda H, et al. Morphological changes in human gastric tumours after eradication therapy of Helicobacter pylori in a short-term follow-up. Aliment Pharmacol Ther. 2005;21(5):559–66. Kobayashi M, Hashimoto S, Nishikura K, Mizuno K, Takeuchi M, Sato Y, et al. Magnifying narrow-band imaging of surface maturation in early differentiated-type gastric cancers after Helicobacter pylori eradication. J Gastroenterol. 2013;48(12):1332–42. Saka A, Yagi K, Nimura S. Endoscopic and histological features of gastric cancers after successful Helicobacter pylori eradication therapy. Gastric Cancer. 2016;19(2):524–30. Kakeji Y, Korenaga D, Tsujitani S, Baba H, Anai H, Maehara Y, et al. Gastric cancer with p53 overexpression has high potential for metastasising to lymph nodes. Br J Cancer. 1993;67(3):589–93. Gabbert HE, Müller W, Schneiders A, Meier S, Hommel G. The relationship of p53 expression to the prognosis of 418 patients with gastric carcinoma. Cancer. 1995;76(5):720–6. Article / Publication Details

First-Page Preview

Received: September 14, 2021
Accepted: May 01, 2022
Published online: June 16, 2022

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.