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17.11.2021 | Original Article

Intestinal-type gastric dysplasia in Helicobacter pylori-naïve patients

verfasst von: Kotaro Shibagaki, Ayako Itawaki, Yoichi Miyaoka, Kenichi Kishimoto, Yusuke Takahashi, Satoshi Kotani, Tsuyoshi Mishiro, Naoki Oshima, Kousaku Kawashima, Norihisa Ishimura, Hideyuki Onuma, Makoto Nagasaki, Mamiko Nagase, Asuka Araki, Kyuichi Kadota, Ryoji Kushima, Shunji Ishihara

Erschienen in: Virchows Archiv | Ausgabe 4/2022

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Abstract

Gastric dysplasia and gastric cancer in Helicobacter pylori (Hp)-naïve patients usually exhibit a gastric phenotype, reflecting gastric mucosa without intestinal metaplasia (IM). We showed that intestinal-type gastric dysplasia (IGD) rarely occurs in the Hp-naïve stomach. In the last 10 years, we treated 1760 gastric dysplasia and gastric cancer patients, with 3.6% (63/1760) being Hp-naïve. Among these, ten were diagnosed with 14 IGDs and enrolled in this retrospective analysis. All lesions were observed by white-light endoscopy (WLE) and narrow-band imaging with magnification endoscopy (NBIME). We analyzed their endoscopic and microscopic features and patient demographics. Five men and five women aged 64 ± 21 years were included. WLE showed the depressed lesions mimicking a benign raised erosion in the prepyloric compartment. Multiple growths were confirmed in 30% (3/10) of patients. NBIME showed a near-regular microstructure and capillaries in 50% (7/14) of lesions with a gastritis-like appearance. Histologically, background mucosa was non-atrophic pyloric gland tissue, but 40.0% of samples (4/10) contained sporadic IM. Most of the lesions (8/14) were low-grade dysplasia, and others had a high-grade component, with one progressing to intramucosal carcinoma. The neoplastic surface was widely covered with foveolar epithelium in 57.1% (8/14). Immunohistochemically, neoplastic cells expressed CDX2 in all patients (14/14), MUC2 and CD10 in 92.9% (13/14), MUC5AC in 14% (2/14), and no expression of MUC6, showing an intestinal phenotype. Ki-67 was overexpressed with a mean labeling index of 58.3 ± 38.5%, and p-53 was overexpressed in 92.9% (13/14), regardless of the dysplastic grade. The IGD rarely occurs in Hp-naïve patients with distinctive clinicopathologic characteristics.

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Titel: Intestinal-type gastric dysplasia in Helicobacter pylori-naïve patients
verfasst von: Kotaro Shibagaki
Ayako Itawaki
Yoichi Miyaoka
Kenichi Kishimoto
Yusuke Takahashi
Satoshi Kotani
Tsuyoshi Mishiro
Naoki Oshima
Kousaku Kawashima
Norihisa Ishimura
Hideyuki Onuma
Makoto Nagasaki
Mamiko Nagase
Asuka Araki
Kyuichi Kadota
Ryoji Kushima
Shunji Ishihara
Publikationsdatum: 17.11.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Virchows Archiv / Ausgabe 4/2022
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-021-03237-9

Neu im Fachgebiet Pathologie

Open Access 15.04.2024 | Biomarker | Schwerpunkt: Next Generation Pathology

Springer Medizin

Intestinal-type gastric dysplasia in Helicobacter pylori-naïve patients

Abstract

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie

Springer Medizin

Abstract

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