{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:54:22Z","timestamp":1761630862658,"version":"3.40.5"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:00:00Z","timestamp":1559174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The typical histology of <jats:italic>Helicobacter <jats:styled-content style=\"fixed-case\">pylori<\/jats:styled-content><\/jats:italic>\u2010uninfected gastric cancer is signet ring cell carcinoma (SRCC) localized in the mucosal layer, but the potential of these SRCCs to invade the submucosal layer is unclear. This study aimed to investigate the clinicopathological characteristics of SRCC in <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content>\u2010uninfected patient and its prevalence in diffuse\u2010type gastric cancer (DGC) within Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled consecutive pure DGC patients diagnosed with the disease either localized in the mucosal layer or with submucosal invasion. <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content> infection was investigated, and the patients were divided into three groups according to histological types: pure SRCC, SRCC with poorly differentiated adenocarcinoma (PDA), and pure PDA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 345 pure DGC patients, 132 (38%), 127 (37%), and 86 (25%) had pure SRCC, SRCC with PDA, and pure PDA histologies, respectively. The prevalence of <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content> infection and the SM ratio were significantly lower in the pure SRCC group than other groups (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Twenty\u2010two (6.4%) patients, including two with submucosal invasion, were negative for <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content> and had mucosal SRCC component in the cancer lesions. Of the 259 SRCC cases (pure SRCC or SRCC\u00a0+\u00a0PDA), <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content>\u2010uninfected cases had different clinicopathological characteristics compared with <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content>\u2010positive cases. Particularly, the ratio of patients with submucosal invasive SRCC was significantly lower in the <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content>\u2010uninfected gastric cancer group than in those with <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content> infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>Helicobacter <jats:styled-content style=\"fixed-case\">pylori<\/jats:styled-content><\/jats:italic>\u2010uninfected gastric cancer is not rare among pure DGC patients in Japan. SRCC in patients without <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content> infection is less likely to be invasive.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14706","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T10:37:32Z","timestamp":1557225452000},"page":"1955-1962","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Potential of <i>Helicobacter pylori\u2010<\/i>uninfected signet ring cell carcinoma to invade the submucosal layer"],"prefix":"10.1111","volume":"34","author":[{"given":"Naoki","family":"Yorita","sequence":"first","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-9059","authenticated-orcid":false,"given":"Masanori","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Boda","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Kotachi","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoko","family":"Nagasaki","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madina","family":"Abuduwaili","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosaku","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Hiyama","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiro","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaharu","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Health Service Center Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Kitadai","sequence":"additional","affiliation":[{"name":"Department of Health Science Prefectural University of Hiroshima  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Hiroshima University Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuaki","family":"Chayama","sequence":"additional","affiliation":[{"name":"Department of Medicine and Molecular Science Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa001999"},{"key":"e_1_2_5_3_1","first-page":"2067","article-title":"Helicobacter pylori infection enhances N\u2010methyl\u2010N\u2010nitrosourea\u2010induced stomach carcinogenesis in the Mongolian gerbil","volume":"58","author":"Sugiyama A","year":"1998","journal-title":"Cancer Res."},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.01987.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23650"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM195506302522601"},{"key":"e_1_2_5_7_1","first-page":"377","article-title":"Lymphoepithelial carcinoma of the stomach with Epstein\u2010Barr virus demonstrated by polymerase chain reaction","volume":"3","author":"Burke AP","year":"1990","journal-title":"Mod. 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