{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:38:37Z","timestamp":1791398317271,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>With the increasing prevalence of persons without <jats:italic>Helicobacter pylori<\/jats:italic> (HP) infection, cases of HP\u2010negative gastric cancer are increasing. Although rare, cases of differentiated adenocarcinoma of the antrum have been reported in HP\u2010negative patients. We collected cases with such lesions and investigated their endoscopic and histological features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of 1965 consecutive patients with early gastric cancer who underwent endoscopic resection between January 2009 and December 2017, we extracted 9 cases of HP\u2010negative differentiated adenocarcinoma located in the antrum (HPN\u2010DAA). The clinical data, endoscopic findings, and histopathological findings were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the nine patients with HPN\u2010DAA, seven were male, and the median age was 53.8\u2009years. The tumor arose from the pyloric gland mucosa in all cases. According to the endoscopic findings, the lesions were flat\u2010elevated or depressed, mimicking varioliform gastritis. Magnifying endoscopy with narrow\u2010band imaging showed the absence of a clear demarcation line or an irregular microvessel\/surface pattern. As for the histopathological findings, eight of the nine lesions were diagnosed as high\u2010grade dysplasia\/intraepithelial neoplasia, while the remaining case was diagnosed as tubular adenocarcinoma with submucosal infiltration. The findings of immunohistochemistry confirmed that three cases were of the intestinal mucin phenotype and six were of the mixed gastric and intestinal mucin phenotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HPN\u2010DAA is a very rarely occurring cancer that had never been recognized earlier. They belong to the new category of HP\u2010negative cancers, and there seems to be a certain number of such cases.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.12518","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T04:52:01Z","timestamp":1614747121000},"page":"470-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Endoscopic and histological features of <i><scp>Helicobacter pylori<\/scp>\u2010<\/i>negative differentiated gastric adenocarcinoma arising in the antrum"],"prefix":"10.1002","volume":"5","author":[{"given":"Maiko","family":"Takita","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Endoscopy NTT Medical Center Tokyo  Tokyo 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