AUTHOR=Wei Yali , Min Congcong , Zhao Chongguang , Li Yubei , Wang Xiaowei , Jing Xue , Yu Yanan , Li Xiaoyu , Yin Xiaoyan 

TITLE=Endoscopic characteristics and high-risk background mucosa factors of early gastric cancer after helicobacter pylori eradication: a single-center retrospective study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1272187

DOI=10.3389/fonc.2023.1272187

ISSN=2234-943X

ABSTRACT=The gastric cancer still develops after successful Helicobacter pylori (Hp)    eradication. In this study, we aimed to explore the characteristics and risk mucosal factors. Methods: A total of 139 early gastric cancers (EGC) diagnosed in 133 patients after successful eradication form January 2016 to December 2021 were retrospectively included as Hp-eradication EGC group and 170 EGCs diagnosed in 158 patients as Hp-positive EGC group. We analyzed the clinical, pathological and endoscopic characteristics between two groups to identify the features of EGC after Hp eradication. Another 107 patients with no EGC after Hp eradication was enrolled as Hp-eradication non-EGC group. The background mucosal factors between Hp-eradication EGC group and Hperadication non-EGC group were compared to analyze the high-risk background mucosal factors of EGC after eradication. In addition, we divided the EGC group after Hp eradication into IIc type and non-IIc type according to endoscopic gross classification to assess the high-risk background factors of IIc-type EGC after Hp eradication.The endoscopic features of EGC after Hp eradication included located in the lower part of the stomach (p＜0.001), yellowish color (p= 0.031), and smaller size (p＜ 3 0.001) . The moderate/severe gastric atrophy (GA), intestinal metaplasia (IM) in the corpus, severe diffuse redness, and map-like redness were risk factors for EGC after eradication (p＜0.001, p＜0.001, p＜0.001, p= 0.005, respectively). The Kyoto classification total score in the EGC group was higher than the non-EGC group (4 vs.3 p<0.001). A multivariate analysis revealed that depressed erosion (OR=3.42, 95 % CI 1.35-8.65, p= 0.009) was an independent risk factor for IIc-type EGC after Hp eradication. Conclusions: EGC after eradication are smaller and yellowish lesions located in lower part of the stomach. The risk background mucosal factors include moderate/severe GA, IM in the corpus, severe diffuse redness and map-like redness. The Kyoto classification total score of 4 or more after successful eradication treatment might indicate EGC risk.In addition, the IIc-type EGC should be cautioned in the presence of depressed erosion after Hp eradication.