The 27th Annual Meeting of The Japanese Society for Helicobacter Research

Program

Presidential Lecture

Speaker
Takashi Kawai(Department of Gastroenterological Endoscopy, Tokyo Medical University)
Chair
Naomi Uemura(Honorary Director, National Center for Global Health and Medicine, Kohnotal Hospital)

Board Chairman Lecture

Speake
Mototsugu Kato(Department of Gastroenterology, National Hospital Organization Hakodate National Hospital)
Chair
Takashi Kawai(Department of Gastroenterological Endoscopy, Tokyo Medical University)

Special Lecture

Speaker
Masahira Hattori(Honorary Professor, University of Tokyo)
Chair
Naoyoshi Nagata(Department of Gastroenterological Endoscopy, Tokyo Medical University)

International Session

『Diagnosis of precancerous lesions: Endoscopically or Histologically –Kyoto classification vs MAPSⅡ』
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International Session

Diagnosis of precancerous lesions: Endoscopically or Histologically –Kyoto classification vs MAPSⅡ

Chair:Toru Ito

(Department of Gastroenterological Endoscopy, Kanazawa Medical University)

Chair:Kazunari Murakami

(Department of Gastroenterology, Oita University)

Mucosal atrophy and intestinal metaplasia are recognized as precancerous lesions of gastric adenocarcinoma. In Japan, many doctors diagnose mucosal atrophy endoscopically according to “Kimura-Takemoto classification”. This procedure is supported by the recent development of image-enhanced endoscopy (IEE) and magnified endoscopy, and also recommended by “Kyoto classification of gastritis”. On the other hand, In Europe MAPS II (Management of epithelial precancerous conditions and lesions in the stomach) recommend for the diagnosis of precancerous lesions not only endoscopic findings but biopsies taken from at least two topographic sites. Especially, the discrepancy is reported endoscopic and histological atrophy at corpus mucosa after the eradication. We would like to make hot discussion about diagnosis of precancerous lesions among Europe, Asia, and Japan in this International session.

Chair
Toru Ito(Department of Gastroenterological Endoscopy, Kanazawa Medical University)
Kazunari Murakami(Department of Gastroenterology, Oita University)
Sergey Kashin(Associate professor, Head of Endoscopy Department, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russia)
Special Remarks
Kentaro Sugano(Honorary Professor, Jichi Medical University)
Hattori Takanori(Honorary Professor, Shiga University of Medical Science)
Key note Lecture Chair
Hisao Tajiri(Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine)
Key note Lecture
Mário Dinis-Ribeiro(ESGE president)
Commentator
Mitsushige Sugimoto(Department of Gastroenterological Endoscopy, Tokyo Medical University)

Symposium1(HP)

『The issues and countermeasures for carrying out H. pylori eradication treatment』
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01. Symposium1

The issues and countermeasures for carrying out H. pylori eradication treatment

Chair:Katsunori Iijima

(Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine)

Chair:Hidekazu Suzuki

(Department of Internal Medicine, Tokai University)

H. pylori infection is considered to be the main cause of gastric cancer, and in Japan, where there are many gastric cancers, eradication treatment for H. pylori-positive persons (H. pylori-infected gastritis), which is estimated to be about 30 million, is being promoted under medical insurance. In the process, some issues and countermeasures have been taken. Regarding eradication treatment, the success rate of primary eradication, which decreased to nearly 70% due to the increase in drug-resistant bacteria, was restored to 80-90% by the regimen using vonoprazan. However, there are still cases where the elimination of the infection is difficult, and countermeasures are required. In addition, H. pylori infection is known to act suppressively on the development of reflux esophagitis or certain allergic diseases, hence the eradication may cancel the suppressive effects and increase the development of such diseases. Further, it is known that H. pylori infection also affects the intestinal flora, and that the intestinal flora is associated with various pathological conditions throughout the body, hence the eradication treatment may modify the risk for various diseases. In this session, we would like to discuss the issues and countermeasures for carrying out national total elimination projects for H. pylori in Japan.

Chair
Katsunori Iijima(Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine)
Hidekazu Suzuki(Department of Internal Medicine, Tokai University)
Special Remarks
Shin'ichi Takahashi(Kosei Hospital)
Commentator
Seiji Futagami(Department of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital)

Symposium2(HP)

『Exploring the pathogenesis of gastric cancer in the era of Helicobacter pylori eradication』
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02. Symposium2

Exploring the pathogenesis of gastric cancer in the era of Helicobacter pylori eradication

Chair:Hiroto Miwa

(Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine)

Chair:Mitsuhiro Fujishiro

(Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine)

Helicobacter pylori (H. pylori) eradication has been performed among wide-range of generations with various states of background gastric mucosa, since RCTs and meta-analyses have revealed that H. pylori eradication significantly reduces the incidence of gastric cancer. Gastric cancers that arise from different backgrounds such as non-atrophic vs. atrophic mucosa, or mild vs. severe intestinal metaplasia may have different mechanisms of cancer development and different clinicopathological characteristics. Because mucosal atrophy would recover over the years after H. pylori eradication, even gastric cancers which have developed in similar degree of gastric atrophy may have different characteristics if the timing of H. pylori eradication was different. Moreover, it is not easy to distinguish between a newly-developed cancer after H. pylori eradication and a preexisting cancer which became detectable after H. pylori eradication. What is the effect of eradication on subsequent development of gastric cancers in case of autoimmune gastritis with H. pylori infection? When H. pylori is eradicated in the early period after establishment of H. pylori infection such as during adolescence, would the cancers have similar characteristics with those that develop in patients with a H. pylori uninfected stomach? What would be the effects of H. pylori eradication for the development of other malignancies such as malignant lymphoma including MALT lymphoma, gastroesophageal junctional cancer, and Barrett’s adenocarcinoma? In this session, we would like to explore the pathogenesis of gastric cancer that develops after H. pylori eradication from various perspectives.

Chair
Hiroto Miwa(Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine)
Mitsuhiro Fujishiro(Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine)
Special Remarks
Masahiro Asaka(Health Sciences University of Hokkaido)
Commentator
Takahisa Furuta(Center for Clinical Research, Hamamatsu University School of Medicine)

Symposium3(HP)

『Forefront of endoscopic diagnosis of gastritis-comparison of endoscopic and pathological findings from the viewpoint of the "Kyoto Classification of Gastritis"』
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03. Symposium3

Forefront of endoscopic diagnosis of gastritis-comparison of endoscopic and pathological findings from the viewpoint of the "Kyoto Classification of Gastritis"

Chair:Akihito Nagahara

(Department of Gastroenterology, Juntendo University School of Medicine)

Chair:Tomoari Kamada

(Department of Health Care Medicine, Kawasaki Medical School)

It has been clarified that most histological gastritis is caused by H. pylori infection, and peptic ulcer and gastric cancer are induced by H. pylori infection. Therefore, the diagnosis of gastritis has come to be used only in the presence of histological gastritis. Upper gastrointestinal endoscopy requires not only detection of gastric cancer but also evaluation of the presence or absence of H. pylori infection and the risk of developing the disease. The "Kyoto Classification of Gastritis" has made it possible to diagnose gastritis based on the endoscopic characteristics of H. pylor-uninfected, current infected, and past infected.
Both endoscopic atrophy and intestinal metaplasia are known as a risk of differentiated adenocarcinoma, and both nodularity and enlarged fold are known as a risk of undifferentiated adenocarcinoma. Furthermore, although the incidence of gastric cancer is halved after eradication, map-like redness and intestinal metaplasia remain a high risk of gastric cancer after H. pylori eradication. However, there are still unclear points regarding the comparison between these endoscopic findings and pathological findings. To elucidate carcinogenic mechanism, it is significantly important to investigate immunohisto-molecular pathological features which causes these findings. Recent advances in various type of image enhanced endoscopy (IEE) make it useful for diagnosing gastritis but their usefulness and value have not been fully investigated.
In this session, we will focus on the comparison between endoscopic findings and pathological findings according to the "Kyoto Classification of Gastritis" and discuss the current status and future prospects of endoscopic diagnosis using white light or IEE. We are looking forward to many interesting presentations.

Chair
Akihito Nagahara(Department of Gastroenterology, Juntendo University School of Medicine)
Tomoari Kamada(Department of Health Care Medicine, Kawasaki Medical School)
Special Remarks
Sakaki Nobuhiro(Foundation for Detection of Early Gastric Carcinoma)
Commentator
Ken Haruma(Department of General Internal Medicine 2)

Symposium4(HP)

『Current status and future prospects of new diagnostic methods for H. pylori』
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04. Symposium4

Current status and future prospects of new diagnostic methods for H. pylori

Chair:Shogo Kikuchi

(Department of Public Health, Aichi Medical University School of Medicine)

Chair:Akiko Shiotani

(Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School)

In the guidelines of the Japanese Society for Helicobacter Research, urea breath test (UBT) is recommended as the most suitable test for diagnosis of eradication, However, the judgment near the cutoff value tends to be unreliable. Similarly, H. pylori antibody test is "negative high" when it is close to the cutoff, and it is known that there are not a few infected patients with the negative high antibody test. Therefore, in the newly published "Recommended guidelines for comprehensive gastric cancer prevention combining effective gastric cancer screening and eradication using the serum antibody test", another appropriate H. pylori test is recommended to those with negative high hp antibody test. However, the proper diagnosis method is not particularly established. Moreover, ABC classification using combined assay for serum pepsinogen (PG) levels and H. pylori antibodies has been widely adopted as an effective tool to determine gastric cancer risk, but the PG value varies depending on the kit even in the same sample. We would expect the subjects on the accuracy and problems of new diagnostic methods, including conventional tests, as well as clinical trials to improve the accuracy are expected.

Chair
Shogo Kikuchi(Department of Public Health, Aichi Medical University School of Medicine)
Akiko Shiotani(Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School)
Special Remarks
Kazumasa Miki(Japan Health Promotion Foundation)
Commentator
Masanori Ito(Department of General Internal Medicine, Hiroshima University Hospital)

Symposium5(HP)

『The future of H. pylori treatment for children, adolescents and young adults』
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05. Symposium5

The future of H. pylori treatment for children, adolescents and young adults

Chair:Masumi Okuda

(Department of Pediatrics, Hyogo College of Medicine)

Chair:Yuji Naito

(Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine)

In Japan, the major cause of gastric cancer is Helicobacter pylori (H. pylori) infection. Therefore, targeting H. pylori eradication is considered an effective strategy to prevent gastric carcinogenesis. The earlier H. pylori eradication has been thought to be more effective in the prevention of future gastric carcinogenesis. Consequently, there are several “screen-and-treat” projects at the prefectural/city level in Japan for junior or senior high school students. In this symposium, we will discuss the up-date results of these “screen-and-treat” projects, and will predict/dream the future of primary gastric cancer prevention.

Chair
Masumi Okuda(Department of Pediatrics, Hyogo College of Medicine)
Yuji Naito(Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine)
Special Remarks
Kazuhide Higuchi(Second Department of Internal Medicine, Osaka Medical College)
Commentator
Osamu Handa(Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School)

Symposium6(HP)

『New evidence of basic research for Helicobacter spp』
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06. Symposium6

New evidence of basic research for Helicobacter spp

Chair:Shin Maeda

(Division of Gastroenterology, Yokohama City University Graduate School of Medicine)

Chair:Yoshio Yamaoka

(Department of Environmental and Preventive Medicine,Faculty of Medicine, Oita University)

Basic research on Helicobacter species was started as a pathogenicity study of bacteria that cause gastritis, gastric ulcer, and gastric cancer. From the study of the mechanism by which this bacterium infects the stomach and causes the disease, the analysis of virulence factors, especially the study of factors such as CagA and VacA, has made great progress. In addition, analysis of host-side factors has revealed various signal transduction abnormalities induced by them, and the mechanism of disease is becoming clear. On the other hand, in the era of H. pylori total eradication, unsolved problems such as the effects remaining after eradication, genomic / epigenome changes caused by this bacterium, mucosal changes such as intestinal metaplasia, and the spread of resistant bacteria still remains. Furthermore, the relationship between the Helicobacter species other than H. pylori and diseases has become a hot topic. In addition, as an application of pioneering methodologies, research on large-scale genome analysis and stem cell research is being actively conducted. In this workshop, we would like to invite a wide range of presentations that show the new direction of Helicobacter basic research.

Chair
Shin Maeda(Division of Gastroenterology, Yokohama City University Graduate School of Medicine)
Yoshio Yamaoka(Department of Environmental and Preventive Medicine,Faculty of Medicine, Oita University)
Special Remarks
Takako Osaki(Department of Infectious Diseases,Kyorin University School of Medicine)
Commentator
Juntaro Mtsuzaki(Keio University Faculty of Pharmacy)

Symposium7(Biota)

『Crosstalk between gastrointestinal disorders and the oral, gastric, small intestine and fecal microbiomes』
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07. Symposium7

Crosstalk between gastrointestinal disorders and the oral, gastric, small intestine and fecal microbiomes

Chair:Toshifumi Okusa

(Department of Microbiota Research Juntendo University Graduate School of Medicine)

Chair:Takayuki Matsumoto

(Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University)

It has been well known that the identification and eradication of H. pylori contributed greatly to the management of gastric cancer and peptic ulcers. However, it still remains uncertain why only a small proportion of subjects infected by H.pylori develop gastroduodenal pathology. Recent research has suggested that gastric microbiota other than H. pylori are closely associated with gastric cancer. It has also become evident that oral microbiota contributes to the development of esophageal cancer and it affects composition of gastric microbiota. Furthermore, a close association between gastric and fecal microbiota under proton-pump inhibitor use and a role of small bowel bacterial overgrowth for the development of irritable bowel syndrome have been suggested worldwide. In the present workshop, we would like to discuss a wide spectrum of recent basic and clinical observations showing significant roles of oro-gastrointestinal microbiota for the pathophysiology, diagnosis, management and prevention of upper gastrointestinal pathology. The moderators sincerely welcome to your contribution.

Chair
Toshifumi Okusa(Department of Microbiota Research Juntendo University Graduate School of Medicine)
Takayuki Matsumoto(Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University)

Meet the expert(Biota)

『Role of the gut microbiota in the pathophysiology of gastrointestinal disorders』
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Meet the expert(Biota)

Role of the gut microbiota in the pathophysiology of gastrointestinal disorders

Chair:Haruhiko Ogata

(Center for Diagnostic and Therapeutic Endoscopy, Keio University)

Chair:Tadakazu Hisamatsu

(Department of Gastroenterology and Hepatology,Kyorin University School of Medicine)

There are about 1,000 species and 100 trillion bacteria in the human GI tract, and it has been clarified that the total number of genes possessed by the gut microbiota is more than 100 times that of human genes. Now, the gut microbiota is considered as a new organ in our body. Recently, there is a growing number of evidences that the gut microbiota plays crucial roles in the pathological conditions of GI tract. In this session, we will discuss on the pathophysiological role of gut microbiota in the GI disorders such as IBD, colon cancer, and functional bowel disease. Therapeutic strategy targeting the gut microbiota will be also discussed by the experts.

Chair
Haruhiko Ogata(Center for Diagnostic and Therapeutic Endoscopy, Keio University)
Tadakazu Hisamatsu(Department of Gastroenterology and Hepatology,Kyorin University School of Medicine)
Special Remarks
Takayuki Matsumoto(Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University)
Commentator
Toshifumi Okusa(Department of Microbiota Research Juntendo University Graduate School of Medicine)