Chronic atrophic gastritis: an update on diagnosis

Botezatu, Adriana; Bodrug, Nicolae

doi:10.15386/mpr-1887

Cited by 15 publications

(13 citation statements)

References 55 publications

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“…There are several approaches to identify these patients, including noninvasive methods. Pre-endoscopic risk assessment is based on demographic and clinical characteristics, such as ethnicity, age, gender, smoking, and H. pylori status; in addition, further insight can be gained by serum concentrations of pepsinogen I and II and gastrin-17 6 , 33 – 36 . The analyses proposed in the present study may provide additional criteria for identifying and monitoring individuals at high risk for developing GC.…”

Section: Discussionmentioning

confidence: 99%

pCLE highlights distinctive vascular patterns in early gastric cancer and in gastric diseases with high risk of malignant complications

Fornasarig

Capuano

Maiero

et al. 2021

Sci Rep

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Endoscopy is widely used to detect and diagnose precancerous lesions and gastric cancer (GC). The probe-based Confocal Laser Endomicroscopy (pCLE) is an endoscopic technique suitable for subcellular resolution and for microvasculature analyses. The aim of this study was to use pCLE to identify specific vascular patterns in high-risk and early stage GC. Mucosal architecture, vessel tortuosity, enlargements and leakage were assessed in patients with autoimmune gastritis and early gastric cancer (EGC). We were able to stratify gastritis patients by identifying distinct vascular profiles: gastritis was usually associated with increased vascularization characterized by a high number of tortuous vessels, which were also found in atrophic autoimmune disease. Leaky and tortuous vessels, distributed in a spatially irregular network, characterized the atrophic metaplastic mucosa. The mucosal vasculature of EGC patients displayed tortuous vessels, but unlike what detected in atrophic gastritis, they appeared patchy, as is in neoplastic gastric tissue. Very importantly, we detected vascular changes even in areas without lesions, supporting the contention that vascular alterations may provide a favorable microenvironment for carcinogenesis. This report confirms that pCLE is a valid endoscopic approach to improve the definition of patients with malignant lesions or at increased risk for GC by assessing vascular changes.

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Section: Discussionmentioning

confidence: 99%

pCLE highlights distinctive vascular patterns in early gastric cancer and in gastric diseases with high risk of malignant complications

Fornasarig

Capuano

Maiero

et al. 2021

Sci Rep

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“…Patients with advanced stages of gastritis, that is, atrophy and/or IM affecting both the antral and corpus mucosa, should be considered at a high risk for GC[ 10 ]. High-definition endoscopy with chromoendoscopy (CE) and image-enhanced endoscopy (IEE) with ME, such as NBI with ME, are better than high-definition and conventional white-light endoscopy[ 10 , 66 , 67 ]. Artificial intelligence (AI) has also been applied to diagnose CAG based on different images.…”

Section: Gastric Precancerous Conditionsmentioning

confidence: 99%

Gastric epithelial histology and precancerous conditions

Yang¹,

Yang²,

Hu³

2022

WJGO

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The most common histological type of gastric cancer (GC) is gastric adenocarcinoma arising from the gastric epithelium. Less common variants include mesenchymal, lymphoproliferative and neuroendocrine neoplasms. The Lauren scheme classifies GC into intestinal type, diffuse type and mixed type. The WHO classification includes papillary, tubular, mucinous, poorly cohesive and mixed GC. Chronic atrophic gastritis (CAG) and intestinal metaplasia are recommended as common precancerous conditions. No definite precancerous condition of diffuse/poorly/undifferentiated type is recommended. Chronic superficial inflammation and hyperplasia of foveolar cells may be the focus. Presently, the management of early GC and precancerous conditions mainly relies on endoscopy including diagnosis, treatment and surveillance. Management of precancerous conditions promotes the early detection and treatment of early GC, and even prevent the occurrence of GC. In the review, precancerous conditions including CAG, metaplasia, foveolar hyperplasia and gastric hyperplastic polyps derived from the gastric epithelium have been concluded, based on the overview of gastric epithelial histological organization and its renewal.

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“…Актуальність проблеми дослідження виникнення передракових станів на етапах від атрофічного гастриту до тяжкої дисплазії на сьогодні не викликає сумнівів [1,2]. Процес формування раку шлунка має повільний перебіг, протягом багатьох років, та зазнає низку послідовних стадій: гастрит, хронічний атрофічний гастрит, кишкова метаплазія (КМ), дисплазія [3].…”

Section: вступunclassified

Features of cytokine balance with the progression of structural changes in the gastric mucosa in patients with atrophic gastritis

Mosiychuk

Tatarchuk

Симонова

et al. 2021

GASTRO

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Background. Until now, the issue of the correlation between the cytokine balance and the progression of structural changes in the gastric mucosa remain completely uncertain. At the same time, the determination of the role of cytokine balance as a component of gastric carcinogenesis will make it possible to substantiate new approaches to managing patients with atrophic gastritis. The purpose was to assess the level of pro- and anti-inflammatory cytokines, vascular endothelial growth factor (VEGF) at the stages of progression of structural changes in the gastric mucosa of patients with atrophic gastritis. Materials and methods. The study included 79 individuals with atrophic gastritis who underwent narrow band imaging endoscopic examination. The patients were divided into groups taking into account the revealed structural changes in the gastric mucosa: group I — 7 people with gastric mucosal atrophy without intestinal metaplasia (IM); group II — 16 individuals with gastric mucosal atrophy with IM limited by the antrum; group III — 45 people with diffuse IM against the background of gastric mucosal atrophy; group IV — 10 individuals with gastric mucosal dysplasia. In all patients, we assessed the level of interleukins (IL-8, IL-10, IL-18), tumor necrosis factor alpha (TNF-α), VEGF. Results. In patients of group IV, the concentration of IL-8 in the blood serum was 18.6 (11.3; 23.9) pg/ml that was significantly higher than in group I (by 5.0 times, p < 0.05), group II (by 3.6 times, p < 0.05) and group III (by 3.4 times, p < 0.05). According to the results of the Kruskal-Wallis test, the probability of a difference in the IL-8 level between the groups was 0.0260. The level of VEGF in the blood serum of patients with gastric mucosal dysplasia was significantly increased compared to that in people with gastric mucosal atrophy without IM (by 1.8 times, p < 0.05) and those with gastric mucosal atrophy with IM (by 1.7 times, p < 0.05). Changes in the cytokine balance towards proinflammatory cytokines were most pronounced in patients of groups III and IV; according to the results of the Kruskal-Wallis test, the probability of a difference in the IL-8/IL-10 ratio between the groups was 0.0207. Conclusions. With the progression of structural changes in the gastric mucosa of patients with atrophic gastritis, an increase in the level of proinflammatory cytokines (IL-8, IL-18 and TNF-α) in the blood serum does not induce the secretion of anti-inflammatory cytokines (IL-10). According to the results of the ROC analysis, the diagnostic criteria for the formation of the risk group for detecting dysplastic changes in the gastric mucosa are VEGF level of more than 341.4 mU/ml (sensitivity — 90.0 %, specificity — 77.2 %) and the level of IL-8 above 14.4 pg/ml (sensitivity — 80.0 %, specificity — 78.3 %).

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Chronic atrophic gastritis: an update on diagnosis

Cited by 15 publications

References 55 publications

pCLE highlights distinctive vascular patterns in early gastric cancer and in gastric diseases with high risk of malignant complications

pCLE highlights distinctive vascular patterns in early gastric cancer and in gastric diseases with high risk of malignant complications

Gastric epithelial histology and precancerous conditions

Features of cytokine balance with the progression of structural changes in the gastric mucosa in patients with atrophic gastritis

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