Japanese Journal of Clinical Oncology Advance Access published online on June 19, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym029
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© 2007 Foundation for Promotion of Cancer Research
Role of Helicobacter pylori Infection and Chronic Inflammation in Gastric Cancer in the Cardia
1 Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima
2 Department of Endoscopy, Hiroshima University Hospital, Hiroshima
3 Health Service Center, Hiroshima University, Higashi-Hiroshima, Hiroshima
4 Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
For reprints and all correspondence: Masanori Ito, Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan. E-mail: maito{at}hiroshima-u.ac.jp
Received September 22, 2006; accepted January 11, 2007
Background: Helicobacter pylori-induced gastritis is an important factor for gastric carcinogenesis. However, it is still controversial whether it is also applicable for cardiac cancer development. Recently, we reported that H. pylori is an important factor for the induction of cardiac inflammation. We examined the status of H. pylori-induced gastritis in patients with cardiac cancer.
Methods: Seventy-five Japanese patients (58 men; mean age, 64.2 years) with cardiac cancer were studied. Cardiac cancer was defined as that mainly located within 2 cm from the squamo-columnar junction (SCJ). Histological gastritis including the cardiac region was evaluated using the biopsy or surgically resected sections. Cardiac inflammation was evaluated at 1 cm distal from SCJ in lesser curvature. Sera were collected and several markers were evaluated. The status of H. pylori infection was evaluated by histology and serum antibodies. Expressions of cytokeratins were examined by immunohistochemical analysis.
Results: Out of 75 patients with cardiac cancer, H. pylori was positive in 71 (95%) patients. The cardiac inflammation was examined in 30 patients (26 with H. pylori and four without H. pylori infection) and we found cardiac inflammation was present in all cases with H. pylori infection. Histologically, H. pylori-related gastritis was also found in the gastric corpus and antrum. Serological data were consistent with the presence of chronic atrophic gastritis. Intestinal metaplasia was found in 18 cases in the cardiac mucosa, and their cytokeratin 7/20 pattern was judged as a gastric pattern in all cases.
Conclusion: H. pylori infection is closely associated with cardiac cancer.
Key Words: atrophic gastritis • cardiac cancer • Helicobacter pylori • cytokeratin