Nobuo Sueoka

Aging increases, and duodenal ulcer reduces the risk for intestinal metaplasia of the gastric corpus in Japanese patients with dyspepsia

Abstract Background and Aims: The classification of gastritis by using the revised Sydney system suggests that there are two types of Helicobacter pylori‐related gastritis. The aim of the present study was to examine the risk factors that might be involved in the presence of either atrophic gastritis or intestinal metaplasia of the gastric corpus of Japanese patients.

ErbB2 without ErbB3 Expression in Metaplastic Columnar Epithelium of Barrett’s Esophagus

Background/Aims: ErbB2 expression in esophageal adenocarcinoma has been shown to correlate with its clinicopathological features. However, expression levels for EGF receptor, erbB2 and erbB3 in specialized columnar epithelium (SCE) of Barrett’s esophagus have yet to be determined. To investigate the relationship between EGF family receptors and Barrett’s esophagus, we examined expression levels for EGF receptor, erbB2 and erbB3 in SCE of Barrett’s esophagus. Methods: 10 consecutive patients with short- and long-segment Barrett’s esophagus, and 10 control subjects without organic esophago-gastric diseases were enrolled. Biopsy samples of Barrett’s mucosa stained or not stained with methylene blue applied endoscopically were used for histological evaluation and Western blot analysis of EGF receptor, erbB2 and erbB3 proteins. Results: Mean length of Barrett’s esophagus was 2.6 cm (range 1–8 cm) and all tissue samples from methylene blue stained Barrett’s mucosa consisted of non-dysplastic SCE. In the Barrett’s group, Western blot analysis showed that EGF receptor and erbB2 were equally and strongly expressed in SCE and squamous epithelium; in contrast, erbB3 expression in SCE was considerably weaker. In control subjects, all proteins showed strong expression for all samples. Immunohistochemical analysis of SCE in Barrett’s esophagus showed positive EGF receptor and erbB2 expression, and no erbB3 expression. Conclusions: ErbB2 is strongly expressed in both non-dysplastic SCE and squamous epithelium, whereas erbB3 expression is essentially limited to the squamous epithelium.

Genotype Configuration in a Case of Primary Gastric Lymphoma with T-cell Phenotype

T-cell malignant lymphoma of the gastrointestinal tract is rare. The genotype of gastric T-cell lymphoma remains unclear. The aim of this study was to elucidate the pathogenesis of a case of primary gastric T-cell lymphoma by using cytogenetics and molecular biology. Gastric biopsy specimens and lymphoma cells in the ascites were examined by immunocytology, cytogenetic analysis, and Southern blot analysis. The histological diagnosis of the gastric lymphoma was diffuse large cell type. T-cell markers were positive in immunocytochemistry of the gastric lymphoma cells and in FACS analysis of lymphoma cells in the ascites. All lymphoma cells in the ascites had complex abnormal karyotypes containing t(8;14)(q24;q32). Southern blot analysis revealed rearrangement of the IgH and C-MYC genes of the lymphoma cells in both the stomach and the ascites, but no comigration of the C-MYC with the JH locus could be detected. The TCR-beta and -gamma genes were in their germ-line configurations. In this patient, although the phenotype was T-cell lymphoma, the karyotype t(8;14)(q24;q32) and genotype had the characteristics of B-cell lymphoma. The unique B-cell genotype configuration and the C-MYC activation suggested that the cellular origin of this rare case of malignant lymphoma with a T-cell phenotype was quite immature lymphocytes.

7098 Endoscopic mucosal resection of small rectal carcinoid tumors: usefulness of high-resolution double-channel video endoscope.

Background: Well-differentiated rectal carcinoids less than or equal to 1 cm are submucosal tumors suited to endoscopic mucosal resection (EMR); they can be cured by adequate local excision. Standard polypectomy using conventional type endoscopy, however, may not provide an optimal margin of resection,necessitating further intervention or surgery. We evaluated the safety and efficacy of EMR using high-resolution double-channel video endoscope for very small rectal carcinoid tumors less than 10 mm even though 0.5 mm. Subjects and Methods: From February 1996 to August 1999, a total of twenty-two rectal carcinoid tumors less than 10 mm in 14 patients was discovered during routine total colonoscopy using a high-resolution double channel video-endoscope (Fujinon EC-410Dcw). The double channel, one for picking up the tumor and another for snaring, was used all procedures. Submucosal saline injection was not utilized. Snare resection was carried out using a blended electrosurgical current. Results: Twenty-two typical rectal carcinoid tumors ranging in size 0.5 to 10 mm were treated. There were no immediate or late complications. Specimens were approximately 5 to 15 mm in diameter. Histopathological diagnoses revealed well-differentiated neuroendocrine tumor. Special stains were positive for chromogranin A, neuron-specific enolase and synaptophysin in all lesions. The endoscopic feature of small carcinoids was yellowish and swelling of normal pit pattern. None of the lesions were umbilicated or centrally ulcerated. There has been no local or distant recurrence with a follow-up of 0.2 to 3.6 years. Conclusions: This technique is ideally suited for small carcinoid tumors less than 1 cm in diameter.