Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]

Lahner, Edith; Zagari, Rocco Maurizio; Zullo, Angelo; Sabatino, Antonio Di; Meggio, Alberto; Cesaro, Paola; Lenti, Marco Vincenzo; Annibale, Bruno; Corazza, Gino Roberto

doi:10.1016/j.dld.2019.09.016

Cited by 111 publications

(80 citation statements)

References 152 publications

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“…The clinical characteristics of patients are shown in Table 1. The genotypes and frequencies observed in our population were TT in 21.88% (28/128) of patients, CT in 53.91% (69/128), and CC in 24.22% (31/128). This distribution followed the Hardy-Weinberg equilibrium (P=0.817).…”

Section: Resultsmentioning

confidence: 59%

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Association of MTHFR C677T polymorphism with severity and localization of chronic atrophic gastritis patients without Helicobacter pylori infection : a case control study

Kong

Dang

et al. 2020

Preprint

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Abstract Background: Previous reports indicate that the methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism plays a role in gastric cancer. However, whether it influences the development and progression of atrophic gastritis remains unclear. We aimed to determine the possible association between the MTHFR 677C>T polymorphism and the severity of atrophic gastritis.Methods: A total 128 patients without Helicobacter pylori infection were included in the study. The presence and severity of gastric atrophy was assessed by histology using OLGA and OLGIM Gastritis Staging System. MTHFR 677C>T genotyping was performed by digital fluorescence molecular hybridization. Categorical variables were analyzed by percentages using the χ2 test.Results: In this study, the TT genotype was significantly more frequent among Helicobacter pylori-negative patients aged ≤44 years (age ≤44 years vs. >44 years, P=0.039). Patients with the TT genotype showed a higher ratio of incisura with atrophy or intestinal metaplasia (TT vs. CC+CT, P=0.02). Furthermore, the TT genotype was associated with more severe lesions compared with the CC+CT genotypes (TT vs. CC+CT for atrophy: P=0.07; for intestinal metaplasia: P=0.01; for moderate-to-severe lesions: P=0.01). OLGA and OLGIM stages III-IV were observed more frequently in patients with the TT genotype compared with the CC+CT genotypes (for OLGA: P=0.003; for OLGIM: P=0.036).Conclusions: The MTHFR 677C>T TT genotype showed an increased risk of moderate-to-severe lesions by OLGA and OLGIM stages, and these results suggest that the MTHFR C677T polymorphism may serve as a predictive marker for precancerous gastric lesions, especially in Helicobacter pylori-negative patients aged ≤44 years.

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Section: Resultsmentioning

confidence: 59%

“…In addition, patients with the TT genotype were found to be at a higher risk of OLGA and OLGIM stages IIIcompared to patients with the CC+CT genotypes. It has been shown previously that OLGA stages I-II are associated with a lower risk while stages III-IV are associated with a higher risk of gastric cancer [24,25].…”

Section: Discussionmentioning

confidence: 92%

Association of MTHFR C677T polymorphism with severity and localization of chronic atrophic gastritis patients without Helicobacter pylori infection : a case control study

Kong

Dang

et al. 2020

Preprint

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“…The timely diagnosis of this precancerous condition is important because high-risk patients may benefit from regular endoscopic follow-up that could provide an early identification of neoplastic conditions, as recommended by the European guidelines ( 4 ). Importantly, serological assessments estimate the worldwide AG prevalence to be 23.9% and 27.0% in the general population and in the selected cohorts, respectively ( 6 ). Similarly, biopsy-based histological analyses suggest that the worldwide AG prevalence is approximately 33.4% and 31.6% in the same groups ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, serological assessments estimate the worldwide AG prevalence to be 23.9% and 27.0% in the general population and in the selected cohorts, respectively ( 6 ). Similarly, biopsy-based histological analyses suggest that the worldwide AG prevalence is approximately 33.4% and 31.6% in the same groups ( 6 ). Thus, AG may potentially affect 1 of 3 adults globally.…”

Section: Introductionmentioning

confidence: 99%

“…Potential noninvasive alternatives include serological tests for pepsinogens, gastrin-17, and antibodies against Helicobacter pylori ( Hp ) ( 8 – 10 ). These “virtual” or “serological” biopsies may be useful for screening subjects at high risk of AG to identify those to refer for histological confirmation ( 6 ). Indeed, low pepsinogen I serum levels and/or a low pepsinogen I/II ratio can be used to identify patients with advanced stages of AG ( 11 – 16 ) in whom endoscopy is recommended, particularly if H. pylori serology is negative ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Autoantibodies Toward ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase Are Reliable Serological Pre-endoscopic Markers of Corpus Atrophic Gastritis

Lahner¹,

Marzinotto

Lampasona

et al. 2020

Clin Transl Gastroenterol

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INTRODUCTION: Noninvasive assessment of corpus atrophic gastritis (CAG), a condition at increased risk of gastric cancer, is based on the measurement of pepsinogens, gastrin, and Helicobacter pylori antibodies. Parietal cell autoantibodies (PCAs) against the gastric proton pump (ATP4) are potential serological biomarkers of CAG. The purpose of this study was to compare the diagnostic performance of PCA and pepsinogen I tests in patients with clinical suspicion of CAG with the histopathological evaluation of gastric biopsies as reference standard. METHODS: A prospective case-finding study was performed on 218 naive adult patients (131 women, median age 65 years) who underwent gastric biopsies to confirm/exclude CAG. Patients with histopathological CAG were defined as cases, conversely as controls. Autoantibodies against the individual alpha (ATP4A) and beta (ATP4B) subunits of ATP4 were measured by luciferase immunoprecipitation, and global PCA and pepsinogen I by enzyme-linked immunosorbent assay. RESULTS: Histopathology classified 107 subjects (49%) as cases (CAG+, autoimmune 81.2%, and multifocal extensive 18.8%) and 111 subjects (51%) as controls (CAG−). In cases, ATP4A, ATP4B, and PCA titers were increased compared with controls, whereas pepsinogen I was reduced ( P < 0.0001 for all). ATP4B, ATP4A, and pepsinogen I tests showed sensitivities of 77%, 75%, and 73% and specificities of 88%, 88%, and 80%, respectively. The receiver operating characteristic (ROC) area under the ROC curve (AUC) of these serological biomarkers confirmed their ability to discriminate cases from controls (ATP4B = 0.838, ATP4A = 0.826, pepsinogen I = 0.775, and PCA = 0.805), whereas the partial ROC-pAUC 90 analysis showed that the ATP4B test had the best diagnostic performance ( P = 0.008 vs ATP4; P = 0.0002 vs pepsinogen I). The presence of autoimmune or extensive gastritis was not significantly different between ATP4B positive or negative cases ( P = 0.217). DISCUSSION: PCAs are promising serological biomarkers for the identification of CAG in high-risk individuals, particularly in an autoimmune pattern but also in an extensive-multifocal atrophy pattern.

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Clinical characteristics and outcomes of pediatric patients with autoimmune gastritis

Granot,

Beinvogl,

Schvimer

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesAutoimmune gastritis (AIG) is a rare chronic inflammatory disorder with potential long‐term sequelae including gastric neoplasia. There is limited data on the natural history of pediatric AIG. We aimed to characterize the clinical course and outcomes of children with AIG.MethodsThis was a multicenter retrospective study that included pediatric patients diagnosed with AIG between January 1, 2000 and December 31, 2021. Diagnosis of AIG was based on the demonstration of histological corpus‐predominant atrophic gastritis, with or without positive antiparietal cell (APCA) or anti‐intrinsic factor (IF) antibodies. Demographic, clinical, laboratory, endoscopic, and histologic data were retrieved, along with follow‐up data.ResultsThirty‐three patients, (23 females, [69.7%], median age 12.0 [interquartile range 7.0–15.0] years at diagnosis) were identified. Twenty‐two patients (66.7%) had positive APCA and/or anti‐IF serology. The most common presenting manifestation was iron deficiency anemia (75%), and accompanying autoimmune disorders were significantly more common in patients with positive serology (62% vs. 18%, p < 0.05). Pseudo‐pyloric or intestinal‐type metaplasia was present at diagnosis in eight patients (24%), and 11 additional patients (33%) developed metaplasia during a median follow‐up time of 27 (17.5–48.3) months. One patient developed a type 1 gastric neuroendocrine tumor. Helicobacter pylori was identified in only one patient, while two patients had prior eradication. Endoscopic and histologic improvements weren't identified in any patients.ConclusionsAIG should be considered in patients with autoimmunity and resistant iron‐deficiency anemia. H. pylori infection may not be associated with pediatric AIG. The development of neuroendocrine tumor in one patient, and the high rates of metaplasia, highlight the importance of surveillance.

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Cited by 111 publications

References 152 publications

Association of MTHFR C677T polymorphism with severity and localization of chronic atrophic gastritis patients without Helicobacter pylori infection : a case control study

Association of MTHFR C677T polymorphism with severity and localization of chronic atrophic gastritis patients without Helicobacter pylori infection : a case control study

Autoantibodies Toward ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase Are Reliable Serological Pre-endoscopic Markers of Corpus Atrophic Gastritis

Clinical characteristics and outcomes of pediatric patients with autoimmune gastritis

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