It is known that the main cause of gastric cancer is infection with Helicobacter pylori (Hp).For this reason, Hp eradication treatment has become widespread, and while the incidence of gastric cancer certainly decreases after eradication, gastric cancer found after eradication treatment has become a problem.
Post-sterilization gastric cancer is characterized by being more difficult to detect endoscopically than normal gastric cancer.After eradication, the surface layer of gastric cancer is covered with epithelium with low grade atypia (ELA), which is close to normal mucosal epithelium. Cancer is said to be overlooked.
There has been disagreement about this ELA, whether it is a partial change in the cancer or an elongated normal epithelium.But this time, a research team at Hiroshima University has proved that ELA is a cancer-derived tissue.
The research team extracted cancer tissue, normal mucosa, and ELA from 10 cases of early gastric cancer covered with ELA that developed after Hp eradication.When an oncogene panel test was performed on these DNAs using a next-generation sequencer, a mutation common to cancer tissue and ELA was found in 10 of 8 cases, indicating that ELA is a tissue originating from cancer. The results shown are obtained.
This result suggests that gastric cancer cells may undergo acquired morphological changes due to changes in the gastric environment.Since it became clear that the cancer cells return to the normal epithelial morphology (returning to the normal epithelial form) due to the disappearance of Helicobacter pylori, which makes it difficult to detect gastric cancer after eradication, it will be overlooked in the future. It is expected to lead to a decrease.The research team also says that elucidation of the mechanism by which ELA occurs is an issue for the future.
Paper information:[Journal of gastroenterology] Genomic landscape of epithelium with low-grade atypia on gastric cancer after Helicobacter pylori eradiation therapy
