Endoscopic Diagnosis Strategy of Raspberry-Shaped Gastric Lesion in Helicobacter Pylori-Uninfected Patient
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. H. pylori Infection Status
- Lack of gastric mucosal atrophy in endoscopy or Kimura–Takemoto Classification of C-1 [16];
- Absence of gastric atrophy in resected specimens as per pathological examinations;
- Negative clinical findings observed for at least one of the following three tests: The 13C-urea breath test (UBT; cutoff value <2.5%, Otsuka, Tokushima, Japan), the H. pylori stool antigen test (Premier Platinum H. pylori SA; Meridian, Cincinnati, OH, USA), or lack of serum immunoglobulin G antibodies against H. pylori (H. pylori Ab; cutoff value < 3 U/mL, Eiken, Tokyo, Japan);
2.3. Immunohistochemical Examination and Phenotypic Classification
2.4. Histopathological Classification of RSGL
2.5. Clinicopathological Assessment
2.6. Endoscopic Assessment
3. Results
3.1. Clinicopathological Features of RSGLs
3.2. Immunohistochemical Features of RSGLs
3.3. Endoscopic Features of RSGLs
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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RSGC | RSBGL | ||||
---|---|---|---|---|---|
GA-FV | GA-FG | GA-FGM | HP | PPI-L | |
Patients (n = 54) | n = 36 | n = 2 | n = 4 | n = 12 | n = 4 |
Age (mean), years (range) | 56.1 (29–81) | 65.5 (51–80) | 51.3 (40–63) | 65.5 (46–76) | 67.8 (54–81) |
Sex (male/female) | 27/9 | 0/2 | 2/2 | 6/6 | 2/2 |
PPI administration (+/−) | 9/27 | 0/2 | 0/4 | 4/8 | 4/0 |
Smoking history (+/−) | 22/14 | 1/1 | 2/2 | 6/6 | 1/3 |
Alcoholic history (+/−) | 13/23 | 1/1 | 1/3 | 3/9 | 0/4 |
Survival periods (mean), months (range) | 26.2 (1–141) | 77.0 (45–109) | 24.3 (1–76) | NA | NA |
Outcome | One death due to another disease | All alive NED | All alive NED | NA | NA |
Lesions (n = 65) | n = 43 | n = 2 | n = 4 | n = 12 | n = 4 |
Endoscopic findings | |||||
Location (U/M/L) | 27/16/0 | 2/0/0 | 4/0/0 | 7/4/1 | 1/1/2 |
(GC/LC/Ant/Post) | 42/0/0/1 | 2/0/0/0 | 0/0/2/2 | 7/5/0/0 | 2/2/0/0 |
Size (average), mm | 3.3 (2–6) | 8.5 (5–12) | 8.0 (4–15) | 4.8 (1–15) | 8.5 (3–20) |
Therapy method (biopsy/CFP/EMR/ESD) | 5/18/20/0 | 0/0/0/2 | 0/0/1/3 | 4/6/2/0 | 2/1/1/0 |
Pathological findings | |||||
Invasion depth (M/SM) | 43/0 | 0/2 | 1/3 | NA | NA |
Distance of SM invasion (average), μm (range) | NA | 250 (200–300) | 433 (300–700) | NA | NA |
Lymphatic invasion (+/−) | 0/43 | 0/2 | 0/4 | NA | NA |
Venous invasion (+/−) | 0/43 | 0/2 | 0/4 | NA | NA |
Lateral margin (+/−) | 0/43 | 0/2 | 0/4 | NA | NA |
Vertical margin (+/−) | 0/43 | 0/2 | 0/4 | NA | NA |
Foveolar hyperplasia around tumor (+/−) | 41/0 | 0/2 | 3/1 | NA | NA |
Covered or mixed non-neoplastic epithelium (+/−) | 13/28 | 2/0 | 1/3 | NA | NA |
RSGC | RSBGL | ||||
---|---|---|---|---|---|
GA-FV | GA-FG | GA-FGM | HP | PPI-L | |
Lesions | n = 40 | n = 2 | n = 4 | n = 9 | n = 4 |
MUC5AC (+/−) | 40/0 | 0/2 | 4/0 | 9/0 | 4/0 |
MUC6 (+/−) | 0/40 | 2/0 | 4/0 | 9/0 | 3/1 |
MUC2 (+/−) | 0/40 | 0/2 | 0/4 | 0/9 | 0/4 |
CD10 (+/−) | 0/40 | 0/2 | 0/4 | 0/9 | 0/4 |
Gastric phenotype (+/−) | 40/0 | 2/0 | 4/0 | 9/0 | 4/0 |
pepsinogen-I (+/−) | 0/40 | 2/0 | 4/0 | 4/5 | 4/0 |
H+/K+-ATPase (+/−) | 0/40 | 2/0 | 4/0 | 3/6 | 4/0 |
Ki-67 MIB-1 labeling index (%) (mean) | 42.8 | 15.0 | 22.5 | NA | NA |
(range) | 5–80 | 10–20 | 10–30 | NA | NA |
p53 over expression (+/−) | 0/40 | 0/2 | 0/4 | NA | NA |
RSGC | RSBGL | ||||
---|---|---|---|---|---|
GA-FV | GA-FG | GA-FGM | HP | PPI-L | |
WLI | n = 43 | n = 2 | n = 4 | n = 12 | n = 4 |
Redness (homogenous/heterogeneous) | 41/2 | 0/2 | 3/1 | 11/1 | 4/0 |
Shape of MCE (polygonal or curved) (+/−) | 43/0 | 2/0 | 4/0 | 12/0 | 4/0 |
Shape of MCE (linear or dotted) (+/−) | 3/40 | 1/1 | 3/1 | 9/3 | 4/0 |
Whitish area around tumor (+/−) | 30/13 | 0/2 | 0/4 | 4/8 | 1/3 |
Submucosal tumor shape (+/−) | 0/43 | 2/0 | 2/2 | 0/12 | 0/4 |
Multiple white and flat elevated lesions (+/−) | 5/38 | 0/2 | 0/4 | 2/10 | 1/3 |
Fundic gland polyp (+/−) | 33/10 | 2/0 | 1/3 | 9/3 | 4/0 |
ME-NBI | n = 33 | n = 2 | n = 4 | n = 11 | n = 3 |
MESDA-G (cancer/non-cancer) | 30/3 | 1/1 | 3/1 | 0/11 | 0/3 |
Demarcation line (+/−) | 33/0 | 2/0 | 4/0 | 11/0 | 3/0 |
Microvascular pattern (irregular/regular/absent) | 30/0/3 | 1/1/0 | 3/0/1 | 0/9/2 | 0/2/1 |
Microsurface pattern (irregular/regular/absent) | 0/33/0 | 0/2/0 | 0/4/0 | 0/11/0 | 0/3/0 |
Irregular inner edge shape of MCE (+/−) | 30/3 | 1/1 | 4/0 | 0/11 | 0/3 |
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Suzuki, N.; Ikeda, A.; Ueyama, H.; Yatagai, N.; Uemura, Y.; Yamamoto, M.; Iwano, T.; Utsunomiya, H.; Uchida, R.; Abe, D.; et al. Endoscopic Diagnosis Strategy of Raspberry-Shaped Gastric Lesion in Helicobacter Pylori-Uninfected Patient. J. Clin. Med. 2023, 12, 5437. https://doi.org/10.3390/jcm12175437
Suzuki N, Ikeda A, Ueyama H, Yatagai N, Uemura Y, Yamamoto M, Iwano T, Utsunomiya H, Uchida R, Abe D, et al. Endoscopic Diagnosis Strategy of Raspberry-Shaped Gastric Lesion in Helicobacter Pylori-Uninfected Patient. Journal of Clinical Medicine. 2023; 12(17):5437. https://doi.org/10.3390/jcm12175437
Chicago/Turabian StyleSuzuki, Nobuyuki, Atsushi Ikeda, Hiroya Ueyama, Noboru Yatagai, Yasuko Uemura, Momoko Yamamoto, Tomoyo Iwano, Hisanori Utsunomiya, Ryota Uchida, Daiki Abe, and et al. 2023. "Endoscopic Diagnosis Strategy of Raspberry-Shaped Gastric Lesion in Helicobacter Pylori-Uninfected Patient" Journal of Clinical Medicine 12, no. 17: 5437. https://doi.org/10.3390/jcm12175437