Although 27 patients in group A’ were
negative for anti-H. pylori antibody, we confirmed the presence of endoscopic atrophy and histologic atrophic change in all 27 patients. However, active gastritis was absent in 24 (89%) patients, and H. pylori immunoreactivity was positive only in 1 (4%) patient. We further evaluated histologic gastritis of non-neoplastic gastric mucosa in group D patients who were also negative for anti-H. pylori antibody. Of 17 patients selleck screening library in group D, eight patients had moderate mononuclear cell infiltration. However, in group A’, all 24 patients without active gastritis showed none or mild mononuclear cell infiltration, which was quite similar to that in patients with previous successful eradication therapy. Our results suggest that patients in group A’ are not true H. pylori-negative
case but have previous H. pylori infection. The distributions of PG I levels and PG I/II ratios supported this hypothesis. Although their anti-H. pylori antibody titer may have been false negative, all our results suggested that the majority of them had clinical features similar to those of patients who had undergone eradication therapy. These patients may have received unexpected H. pylori eradication because they did not have a history of H. pylori eradication therapy as far as we carefully interviewed. this website This could be because antibiotics such as penicillin, macrolide, and quinolone are commonly used for other diseases in Japan. On the other hand, it may be caused by misunderstanding of patients concerning previous eradication therapy or by insufficient explanation from the chief physician. With regard to serum markers for gastric mucosal atrophy, these patients mostly had high PG I/II ratios and low PG I levels (so called group α) [26]. Yanaoka
et al. [26] reported that people with this classification had the lowest mafosfamide risk of gastric cancer. However, we found that a part of these patients had a similar potential for generating metachronous cancer in a cohort study. We identified a certain number of high-risk patients for gastric epithelial neoplasm in group A, even though the risk in this group is expected to be particularly low. It is clinically important to identify the high-risk patients mixed into group A and exclude them from this group to develop an effective examination for gastric cancer. To this end, one method may involve performing an imaging examination using radiography or endoscopy at least once during the lifetime of all people in group A, because we confirmed that all gastric epithelial neoplasm patients in group A except for true H. pylori-negative patients exhibited atrophy of the gastric mucosa. However, this is not a realistic method with respect to patient safety, staffing, and economic benefit.