Diagnosis and Management of High Risk Group for Gastric Cancer

Abstract

Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval.

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

“…Therefore, it would be a challenge to diagnose gastric precancerous changes in an asymptomatic population, using a non-invasive technique [11]. One of the most promising non-invasive tests for diagnosis of GA is the detection of pepsinogen (PG) levels in blood [12,13].…”

“…To reduce the prevalence of GC, it is important to identify and manage the high risk group patients with precancerous lesions [11]. Therefore, it would be a challenge to diagnose gastric precancerous changes in an asymptomatic population, using a non-invasive technique [11].…”

“…27 No 1: [11][12][13][14][15][16][17] At present, the gold standard for diagnosis of gastric mucosal changes is the biopsy performed during an upper gastrointestinal endoscopy followed by histological examination [3,6]. Evaluation of the histological status of the mucosa can be performed using the updated Sydney System, the Operative Link on Gastritis Assessment (OLGA) and the Operative Link for Gastric Intestinal Metaplasia assessment (OLGIM) systems.…”

Gastric Intestinal Metaplasia Is the Most Common Histopathological Phenotype among Endoscopically Diagnosed Atrophic Gastritis Patients in North-East China

“…Detection of precancerous gastric lesions at an early stage complemented with a follow-up strategy for high risk groups would probably aid in declining the mortality rate in GC patients. Helicobacter pylori (H. pylori) infection, salt intake, smoking, alcohol, family history of gastric cancer, atrophic gastritis (AG) and intestinal metaplasia (IM) are established risk factors of gastric cancer [4].…”

Moxibustion Alleviates Gastric Precancerous Lesions in Rats by Promoting Cell Apoptosis and Inhibiting Proliferation-Related Oncogenes

“…The typical pathological features of gastric precancerous lesions (GPL) are gastric mucosa dysplasia and intestinal metaplasia, which is closely associated with gastric carcinogenesis (Marques-Silva et al, 2014; Yoon and Kim, 2015). Helicobacter pylori infection, dietary habits, immune factors and duodenal reflux were involved in the mechanism of GPL (Pan et al, 2014 United States), electrophoretic apparatus (Bio-Rad Laboratories, Inc., Hercules, California, USA), polymerase chain reaction system (Applied Biosystems co., Ltd., Waltham, MA, USA), electrophoresis groove (Beijing Donglin Changsheng biotechnology co., Ltd., Beijing, China).…”