1. Hee-Won Kwak, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Myeong-Cherl Kook, Keun Won Ryu and Young-Woo Kim Journal of Gastroenterology and Hepatology 29 (2014) 1671–1677 전임의 정명화 Characteristics of gastric cancer according to Helicobacter pylori infection status

2. Helicobacter pylori (Hp) Strong risk factor of gastric cancer (HR: 2.7- 5.9) The proportions of Hp-negative gastric cancer 13.8% to 24.6% in Western countries 0.66% to 11.6% in Eastern countries Hp- negative gastric cancer is worse prognostic factor In this study, classified gastric cancer according to Hp infection status and compared the clinicopathologic characteristic to determine the prognostic implication Introduction

3. Patients and methods 2574 patient at the National Cancer Center Hospital in Korea Retrospective study 2007. 6 – 2012. 4 Who was diagnosed with gastric adenocarcinoma by histologic confirmation and treated with surgery (n= 2219) or endoscopic resection (n = 355) 1. Inadequately evaluated for glandular atrophy or intestinal metaplasia 2. Not grouped according to Lauren’s classification 3. Inadequate evaluation for Hp infection status

4. Patients and methods Methods for evaluating Hp infection status. Histology, rapid urease test, serology test (Ig G Ab) Biopsy site: lesser curvature of the antrum, lesser curvature of high body (4cm distal from GE juction)  histology greater curvature of highbody body  rapid urease test Histology : Hp density, neutrophil activity, chronic inflammation, grandular atrophy, intestinal metaplasia Histological staging : Operative Link on Gastritis Assessment (OLGA) and Operative Link on Intestinal Metaplasia Assessment (OLGIM) staging systems using the Updated Sydney Scoring System

5. Patients and methods Definition of GCs according to Hp infection status. GCs with current Hp infection (HpC-GC) : Histology (+) or histology (-)  RUT (+) and serology (+) GCs without current Hp - GCs with past Hp infection (HpP-GCs) - Not associated with Hp infection (HpN-GCs) Serologic HpP-GCs: only serology (+) Histological HpP-GCs : all (-) at histology, RUT, serology but OLGA ≥ 2 stage, OLGIM ≥ 1 stage

6. Results 53.3 %46.6 %

7. Results Hbs Ag HBV DNA

8. Results

10. Conclusion Most GCs without current Hp infection were associated with past infection. The presence of GCs that were truly not related to Hp infection was rare (2.3%). The finding that patients with past infection had a decreased proportion of diffuse-type GCs compared with those with current infections may support Hp treatment strategy in middle-aged patients.