ENDOSCOPIC GRADING OF GASTRIC INTESTINAL METAPLASIA PREDICTS EARLY GASTRIC NEOPLASIA: CAN WE REPLACE HISTOLOGY ASSESSMENT ALSO IN THE WEST?

2020 ◽  
Author(s):  
P Marcos ◽  
G Brito-Gonçalves ◽  
D Libânio ◽  
I Pita ◽  
R Castro ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
The West ◽  
Gastric Intestinal Metaplasia ◽  
Gastric Neoplasia

Endoscopic grading of gastric intestinal metaplasia on risk assessment for early gastric neoplasia: can we replace histology assessment also in the West?

Gut ◽  
2020 ◽  
Vol 69 (10) ◽  
pp. 1762-1768 ◽  
Author(s):  
Pedro Marcos ◽  
Gisela Brito-Gonçalves ◽  
Diogo Libânio ◽  
Inês Pita ◽  
Rui Castro ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Intestinal Metaplasia ◽  
Matched Control ◽  
Gastric Intestinal Metaplasia ◽  
Control Subjects ◽  
Gastric Neoplasia ◽  
Endoscopic Classification ◽  
Control Study

ObjectivesTo assess the value of endoscopic grading of gastric intestinal metaplasia (EGGIM), operative link on gastritis assessment (OLGA) and operative link on gastric intestinal metaplasia (OLGIM) on risk stratification for early gastric neoplasia (EGN) and to investigate other factors possibly associated with its development.DesignSingle centre, case–control study including 187 patients with EGN treated endoscopically and 187 age-matched and sex-matched control subjects. Individuals were classified according to EGGIM, OLGA and OLGIM systems. EGN risk according to gastritis stages and other clinical parameters was further evaluated.ResultsMore patients with EGN had EGGIM of ≥5 than control subjects (68.6% vs 13.3%, p<0.001). OLGA and OLGIM stages III/IV were more prevalent in patients with EGN than in control subjects (68% vs 11%, p<0.001, and 61% vs 3%, p<0.001, respectively). The three systems were the only parameters significantly related to the risk of EGN in multivariate analysis: for EGGIM 1–4 (adjusted OR (AOR) 12.9, 95% CI 1.4 to 118.6) and EGGIM 5–10 (AOR 21.2, 95% CI 5.0 to 90.2); for OLGA I/II (AOR 5.0, 95% CI 0.56 to 44.5) and OLGA III/IV (AOR 11.1, 95% CI 3.7 to 33.1); for OLGIM I/II (AOR 11.5, 95% CI 4.1 to 32.3) and OLGIM III/IV (AOR 16.0, 95% CI 7.6 to 33.4).ConclusionThis study confirms the role of histological assessment as an independent risk factor for gastric cancer (GC), but it is the first study to show that an endoscopic classification of gastric intestinal metaplasia is highly associated with that outcome. After further prospective validation, this classification may be appropriate for GC risk stratification and may simplify every day practice by reducing the need for biopsies.

Kimura–Takemoto Classification: A Tool to Predict Gastric Intestinal Metaplasia Progression to Advanced Gastric Neoplasia

2021 ◽  
Author(s):  
Leyla Maric ◽  
Daniel Castaneda ◽  
Harjinder Singh ◽  
Pablo Bejarano ◽  
Brenda Jimenez Cantisano ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Gastric Intestinal Metaplasia ◽  
Gastric Neoplasia

scholarly journals Improving the Diagnosis and Treatment of Early Gastric Cancer in the West

2021 ◽  
pp. 1-12
Author(s):  
Diogo Libânio ◽  
Raquel Ortigão ◽  
Pedro Pimentel-Nunes ◽  
Mário Dinis-Ribeiro
Keyword(s):  
Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Curative Resection ◽  
Narrow Band Imaging ◽  
Scoring Systems ◽  
Cost Effective ◽  
Endoscopic Surveillance ◽  
The West ◽  
Gastric Intestinal Metaplasia ◽  
Staging Systems

Gastric cancer is the third leading cause of cancer-related death. In Western countries, its lower prevalence and the absence of mass screening programmes contribute to late diagnosis and a slower implementation of minimally invasive treatments. A secondary prevention strategy through endoscopic surveillance of patients at high risk of intestinal-type gastric adenocarcinoma or by screening gastric cancer within colorectal screening programmes is cost-effective in intermediate-risk countries, though the identification of these patients remains challenging. Virtual chromoendoscopy with narrow-band imaging improves the accuracy of endoscopic diagnosis, significantly increasing the sensitivity for intestinal metaplasia while preserving specificity. Endoscopic grading of gastric intestinal metaplasia is feasible, correlates well with histological staging systems and also with gastric neoplasia risk and can be used to stratify risk. Endoscopic submucosal dissection (ESD) in the West achieves efficacy and safety outcomes similar to those reported for Eastern countries, and the long-term disease-specific survival is higher than 95%. A prospective comparative study with gastrectomy confirms its higher safety and its benefits concerning health-related quality of life. However, ESD is associated with a 5% risk of postprocedural bleeding and a 20% risk of non-curative resection. The knowledge of risk factors for adverse events and non-curative resection can improve patient selection. The risk of metachronous lesions after ESD is high (3–5% per year), and endoscopic surveillance is needed. The management of patients with non-curative resection can be optimized using risk scoring systems for lymph node metastasis.

ENDOSCOPIC GRADING FOR GASTRIC INTESTINAL METAPLASIA (EGGIM): A MULTICENTRE VALIDATION STUDY

2018 ◽  
Author(s):  
G Esposito ◽  
P Pimentel-Nunes ◽  
S Angeletti ◽  
R Castro ◽  
D Libânio ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Validation Study ◽  
Gastric Intestinal Metaplasia

Metaplasia — A Transdifferentiatlon Process that Facilitates Cancer Development: The Model of Gastric Intestinal Metaplasia

2006 ◽  
Vol 12 (1-2) ◽  
pp. 3-26 ◽  
Author(s):  
Patricia Mesquita ◽  
Raquel Almeida ◽  
Nuno Lunet ◽  
Celso A. Reis ◽  
Luis Filipe Santos Silva ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Cancer Development ◽  
Gastric Intestinal Metaplasia

scholarly journals Significance of pepsinogen in screening for gastric intestinal metaplasia in Guangdong, China

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199049
Author(s):  
Xujuan Liu ◽  
Min Zhang ◽  
Riyu Luo ◽  
Keran Mo ◽  
Xingxiang He
Keyword(s):  
Logistic Regression ◽  
Intestinal Metaplasia ◽  
Single Factor ◽  
Antibody Testing ◽  
Cross Sectional ◽  
Gastric Intestinal Metaplasia ◽  
Risk Detection ◽  
Tree Models ◽  
Single Factor Analysis ◽  
Serological Biomarkers

Objective Diagnosis of gastric intestinal metaplasia (GIM) relies on gastroscopy and histopathologic biopsy, but their application in screening for GIM is limited. We aimed to identify serological biomarkers of GIM via screening in Guangdong, China. Methods Cross-sectional field and questionnaire data, demographic information, past medical history, and other relevant data were collected. Blood samples were collected for pepsinogen (PG)I, PGII, gastrin-17, and Helicobacter pylori antibody testing, and gastroscopy and histopathologic biopsy were performed. Single factor and logistic regression analyses were used to evaluate the correlation between these indicators and GIM, and decision tree models were used to determine the cut-off points between indicators. Results Of 443 participants enrolled, 87 (19.6%) were diagnosed with GIM. Single factor analysis showed that pepsin indicators (PGI, PGII, and PGI/PGII ratio) and the factors Mandarin as native language, urban residency, hyperlipidemia, and age were associated with GIM. Logistic regression analysis showed that PGI and age were associated with GIM. Conclusions Age is an important factor for predicting GIM progression; age >60 years increased its risk. Detection of GIM was higher in individuals with PGI levels >127.20 ng/mL, which could be used as a threshold indicating the need to perform gastroscopy and histopathologic biopsy.

scholarly journals Helicobacter Infection and Gastric Adenoma

2021 ◽  
Vol 9 (1) ◽  
pp. 108
Author(s):  
Simone Bertz ◽  
Miriam Angeloni ◽  
Jan Drgac ◽  
Christina Falkeis ◽  
Corinna Lang-Schwarz ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Clinicopathological Parameters ◽  
Consecutive Series ◽  
Gastric Adenoma ◽  
Gastric Intestinal Metaplasia ◽  
Pyloric Gland Adenoma ◽  
Hereditary Tumor Syndromes ◽  
Mucosal Changes ◽  
H Pylori ◽  
Insight Into

Background: We aimed to provide insight into the actual frequencies of gastric adenoma types and their association with gastritis status and associated mucosal changes with a focus on Helicobacter infection and the operative link on gastritis assessment (OLGA)/operative link on gastric intestinal metaplasia assessment (OLGIM) staging. Methods: From the archive of the Institute of Pathology in Bayreuth, we collected a consecutive series of 1058 gastric adenomas diagnosed between 1987 and 2017. Clinicopathological parameters retrieved from diagnostic reports included adenoma type and localization, associated mucosal changes in antrum and corpus (i.e., type of gastritis, the extent of intestinal metaplasia and atrophy), gender, date of birth, and date of diagnosis. Results: Intestinal-type adenoma was the most frequent adenoma (89.1%), followed by foveolar-type adenoma (4.3%), pyloric gland adenoma (3.4%), adenomas associated with hereditary tumor syndromes (2.8%), and oxyntic gland adenoma (0.4%). Adenomas were found in the background of Helicobacter pylori (H. pylori) gastritis in 23.9%, Ex-H. pylori gastritis in 36.0%, autoimmune gastritis in 24.8%, chemical reactive gastritis in 7.4%, and others in 0.1%. More than 70% of patients with gastric adenomas had low-risk stages in OLGA and OLGIM. Conclusions: We found a higher frequency of foveolar-type adenoma than anticipated from the literature. It needs to be questioned whether OLGA/OLGIM staging can be applied to all patients.

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