2015 Volume 57 Issue 4 Pages 1210-1218
Gastric cancer detected after successful Helicobacter pylori (H. pylori) eradication is characterized by the following three points. (1) It exhibits a gastritis-like mucosal pattern and is often ill-delineated. (2) Although it exhibits gastritis-like gastric mucosa, it is present with a part or an area of a different pattern from the background mucosa. It has the characteristics of cancer to exhibit an area. (3) NBI magnifying endoscopy showed a mucosal pattern area of a white zone exhibiting “morphological heterogeneity” and “direction diversity”, although such an area is hard to detect. Background mucosa tends to exhibit a pattern and arrangement with more regularity after successful H. pylori eradication. Compared with such background mucosa, an area exhibiting “morphological heterogeneity” and “direction diversity” is relatively easily diagnosed as cancer. Endoscopy with the three characteristics in mind is a key to diagnosing gastric cancer after successful H. pylori eradication, including diagnosis of its expansion.
