pylori eradication with histological changes in the gastric remnant to clarify the importance of H. pylori eradication on the gastric remnant. Eight patients who underwent distal gastrectomy for primary gastric cancer with Billroth I construction at Aichi Cancer Center Aichi Hospital were included (Table 1). Informed consent was given by all patients in

accordance with the Helsinki Declaration, and the study was approved by the Ethics Committee of Aichi Cancer Center Aichi Hospital. All patients were H. pylori positive and consequently underwent this website eradication therapy with proton-pump inhibitor-based triple therapy (lansoprazole 30 mg bid, amoxicillin 750 mg bid, and clarithromycin 400 mg bid for 1 week). Eradication was defined as a negative result for H. pylori by 13C-urea breath test at 2 months following therapy. After H. pylori eradication therapy, we followed them for 9 years. Upper gastroenteroscopy series were done before and at 1, 3, 5, 7, and 9 years after eradication, and at each time of endoscopy, biopsy specimens were taken one each from the lesser and greater curvatures of the gastric corpus. Histological changes, including chronic inflammation, activity, atrophy, and intestinal metaplasia, were evaluated using the updated Sydney system.[10] All histologic evaluations were conducted without knowledge of clinical or endoscopic data. Successful

eradication was confirmed by urea breath test in all eight patients. Chronic inflammation scores were improved after eradication at both the lesser (mean scores ± SD: before eradication, 2.9 ± 0.5; MK0683 datasheet 1 year after, 2.3 ± 0.4; 3 years, 1.8 ± 0.3; 5 years, 1.5 ± 0.3; 7 years, 1.3 ± 0.3; and 9 years, 1.0 ± 0.3) and greater curvatures (before, 2.9 ± 0.4; 1 year after, 1.9 ± 0.3; 3 years, 1.4 ± 0.4; 5 years, 1.3 ± 0.3; 7 years, 1.1 ± 0.2; and 9 years, 0.6 ± 0.3) (Figs 1, 2) of the gastric corpus.

Atrophy scores improved more quickly after eradication 上海皓元医药股份有限公司 than chronic inflammation scores at both the lesser (before, 2.4 ± 0.5; 1 year after, 1.8 ± 0.4; 3 years, 0.8 ± 0.3; 5 years, 0.3 ± 0.1; 7 years, 0.0; and 9 years, 0.0) and greater curvatures (before, 2.2 ± 0.4; 1 year after, 1.3 ± 0.3; 3 years, 0.5 ± 0.3; 5 years, 0.0; 7 years, 0.0; and 9 years, 0.0) (Figs 2, 3). Endoscopic abnormal findings, such as thickness of mucosal folds, exudates from mucosa, and redness of mucosa were improved in all cases 9 years after eradication (Fig. 4). No secondary stomach cancers were found on endoscopy. This study showed that H. pylori eradication improved the histological findings of the gastric remnant among patients who had undergone distal gastrectomy for primary gastric cancer. These data indicate that H. pylori eradication therapy might prevent the development of metachronous gastric cancer after gastric resection. Helicobacter pylori are regarded as a definite carcinogen[11] and a trigger for the sequence of carcinogenesis, because there is strong evidence for H.