Retrospective study of the characteristics of early gastric cancer with surrounding map-like redness after successful Helicobacter pylori eradication.

[BACKGROUND] Map-like redness (MLR) is a high-risk membrane factor for early gastric cancer (EGC) after the successful eradication of Helicobacter pylori (Hp). This study aimed to analyze the clinical, endoscopic, and pathological characteristics of EGC with surrounding MLR after successful Hp eradication and evaluate the effect of endoscopic submucosal dissection (ESD) resection.

[METHODS] This retrospective study comprised 23 patients with EGC and surrounding MLR after Hp eradication (MLR group) and 135 patients with EGC without a surrounding MLR (non-MLR; NMLR group). The clinical, pathological, and endoscopic characteristics were compared, and the effect of ESD resection was evaluated.

[RESULTS] A total of 158 patients were enrolled (age range: 41-77 years). The MLR group had a higher proportion of males (P = 0.020) and more severe atrophy (P = 0.003) and intestinal metaplasia (P = 0.007) than the NMLR group. The endoscopic features of the MLR group included localization in the middle part of the stomach (P < 0.001), a red color (P = 0.002), a larger size (P = 0.015), a greater proportion of type IIb tumors (P < 0.001), and unclear lesion borders (P < 0.001) compared to the NMLR group. Differentiated adenocarcinoma was the main histological type in the MLR group (P = 0.023). No significant difference in curative resection rates was observed between the groups.

[CONCLUSION] The MLR group presented with a greater risk of pathological upgrading after ESD. The findings indicate that ESD is most effective for treating EGC with adjacent MLR after Hp eradication.