胃と腸55巻8号

2020年07月発行

今月の主題 H. pylori未感染胃の上皮性腫瘍 主題

H. pylori未感染胃上皮性腫瘍の臨床的特徴

著者： 鈴木翔¹ 上堂文也² 河上洋¹ 石原立²

所属機関： ¹宮崎大学医学部附属病院消化器内科 ²大阪国際がんセンター消化管内科

ページ範囲：P.981 - P.987

要旨●H. pyloriの感染率は低下しているため，H. pylori感染胃癌と比べてH. pylori未感染胃癌は相対的に増加すると予想される．今回，2010年1月〜2016年5月の期間に当院（大阪国際がんセンター）で経験した，H. pylori未感染胃癌の臨床的特徴を考察した．H. pylori未感染胃癌の頻度は早期胃癌全体の1.26%と低く，若年例，U領域，未分化型癌が多かった．また，分化型癌の粘液形質は胃型の割合が高かった．

参考文献

1）International Agency for Research on Cancer. Schistosomes, liver flukes and Helicobacter pylori. IARC Monogr Eval Carcinog Risks Hum　61：177-240, 1994

2）Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med　345：784-789, 2001

3）Kobayashi M, Takeuchi M, Ajioka Y, et al. Mucin phenotype and narrow-band imaging with magnifying endoscopy for differentiated-type mucosal gastric cancer. J Gastroenterol　46：1064-1070, 2011

4）Ueyama H, Yao T, Nakashima Y, et al. Gastric adenocarcinoma of fundic gland type（chief cell predominant type）：proposal for a new entity of gastric adenocarcinoma. Am J Surg Pathol　34：609-619, 2010

5）菊池正悟．Helicobacter pyloriは胃癌の原因か．胃と腸　42：915-920, 2007

6）Hirayama Y, Kawai T, Otaki J, et al. Prevalence of Helicobacter pylori infection with healthy subjects in Japan. J Gastroenterol Hepatol　29（Suppl 4）：16-19, 2014

7）Wang C, Nishiyama T, Kikuchi S, et al. Changing trends in the prevalence of H. pylori infection in Japan（1908-2003）：a systematic review and meta-regression analysis of 170,752 individuals. Sci Rep　7：15491, 2017

8）日本ヘリコバクター学会（編）．WS2小児期のH. pylori感染：感染経路と感染実態．第19回日本ヘリコバクター学会学術集会プログラム抄録集，pp 90-94, 2013

9）上村直実．H. pylori感染と胃発癌研究の進歩本邦におけるH. pylori感染と胃癌発生・進展の関連性．日臨　61：25-29, 2003

10）Kato S, Matsukura N, Tsukada K, et al. Helicobacter pylori infection-negative gastric cancer in Japanese hospital patients：Incidence and pathological characteristics. Cancer Sci　98：790-794, 2007

11）Kakinoki R, Kushima R, Matsubara A, et al. Re-evaluation of histogenesis of gastric carcinomas：a comparative histopathological study between Helicobacter pylori-negative and H. pylori-positive cases. Dig Dis Sci　54：614-620, 2009

12）Yoon H, Kim N, Lee HS, et al. Helicobacter pylori-negative gastric cancer in South Korea：incidence and clinicopathologic characteristic. Helicobacter　16：382-388, 2011

13）Matsuo T, Ito M, Tanaka S, et al. Low prevalence of Helicobacter pylori-negative gastric cancer among Japanese. Helicobacter　16：415-419, 2011

14）Ono S, Kato M, Suzuki M, et al. Frequency of Helicobacter pylori-negative gastric cancer and gastric mucosal atrophy in Japanese endoscopic submucosal dissection series including histological, endoscopic and serological atrophy. Digestion　86：59-65, 2012

15）藤崎順子，山本智理子，堀内祐介，他．Helicobacter pylori陰性未分化型早期胃癌の特徴．胃と腸　49：854-861, 2014

16）八板弘樹，蔵原晃一，川崎啓祐，他．Helicobacter pylori陰性分化型胃癌の臨床病理学的特徴—臨床の立場から．胃と腸　49：863-873, 2014

17）Kwak HW Choi IJ, Cho SJ, et al. Characteristics of gastric cancer according to Helicobacter pylori infection status. J Gastroenterol Hepatol　29：1671-1677, 2014

18）Kim HJ, Kim N, Yoon H, et al. Comparison between resectable Helicobacter pylori-negative and positive gastric cancers. Gut Liver　10：212-219, 2016

19）Dixon MF, Genta RM, Yardley JH, et al. Classification and grading of gastritis. The updated Sydney system. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol　20：1161-1181, 1996

20）Kishikawa H, Kimura K, Ito A, et al. Predictors of gastric neoplasia in cases negative for Helicobacter pylori antibody and with normal pepsinogen. Anticancer Res　35：6765-6772, 2015

21）Kato T, Yagi N, Kamada T, et al. Diagnosis of Helicobacter pylori infection in gastric mucosa by endoscopic features：a multicenter prospective study. Dig Endosc　25：508-518, 2013

22）吉村大輔，吉村理江，加藤誠也，他．H. pylori未感染胃癌—現状と未来の課題．胃と腸　53：658-670, 2018

23）Yamada A, Kaise M, Inoshita N, et al. Characterization of Helicobacter pylori-naïve early gastric cancers. Digestion　98：127-134, 2018

24）Ueyama H, Matsumoto K, Nagahara A, et al. Gastric adenocarcinoma of the fundic gland type（chief cell predominant type）. Endoscopy　46：153-157, 2014

25）Shibagaki K, Fukuyama C, Mikami H, et al. Gastric foveolar-type adenomas endoscopically showing a raspberry-like appearance in the Helicobacter pylori-uninfected stomach. Endosc Int Open　7：E784-791, 2019

26）Kanesaka T, Uedo N, Yao K, et al. New subtype of gastric adenocarcinoma：mixed fundic and pyloric mucosa-type adenocarcinoma. Clin J Gastroenterol　10：224-228, 2017

27）藤崎順子，堀内裕介，平澤俊明，他．H. pylori未感染未分化型胃癌の診断のこつ．日消誌　58：1001-1009, 2016

28）Kimura K. Chronological transition of the fundic-pyloric border determined by stepwise biopsy of the lesser and greater curvatures of the stomach. Gastroenterology　63：584-592, 1972