Intestinal metaplasia, intraepithelial neoplasia and gastric carcinogenesis

AIM: The purpose of the study is to investigate the occurrence of the main forms of chronic gastritis, metaplastic and dysplastic changes in the gastric mucosa, the degree of their severity, and to assess their potential risk for the development of gastric cancer. MATERIALS AND METHODS: The study involved 2982 patients who underwent esophagogastroduodenoscopy with a standard biopsy of the gastric mucosa for morphological assessment and bacterioscopy. If autoimmune gastritis was suspected, an additional serological diagnosis was performed. When detecting intestinal metaplasia of the gastric mucosa as well as neoplastic changes according to the histological report, the description of this report was analyzed in order to identify possible equivalents in the macroscopic description of the mucous membrane. RESULTS: Out of 2982 histological studies of gastric mucosa biopsies, 1273 cases (42.7%) were found to contain H. pylori contamination. In 726 cases (24.3%), intestinal metaplasia. 66 biopsies (2.21%) showed the presence of low-grade intraepithelial neoplasia of the mucosa, 2 biopsies showed indeterminate neoplasia and 4 biopsies showed high-grade neoplasia. In 3 out of the total number of the samples, intravascular gastric adenocarcinoma was detected. In 168 cases (5.6%), gastritis was detected with predominant inflammation of the fundal region characteristic of autoimmune gastritis. In 286 biopsies (10.6%), inflammatory and/or atrophic changes and/or metaplastic changes were preserved, which, as a rule, did not have high activity and pronounced inflammation. In the remaining 1279 cases (42.9%), there was no significant inflammation or atrophic changes. The analysis of endoscopic findings showed that the detectability of intestinal metaplasia of the gastric mucosa without a biopsy study was 13.3%. DISCUSSION OF THE RESULTS: According to the results of the conducted research and analysis, it can be stated that at present, the correct diagnosis of chronic gastritis with the establishment of the etiological factor, prognosis and risks of stomach cancer development is practically not feasible within the modern health care system. This not only deprives a doctor of the opportunity to make a correct diagnosis and prescribe adequate treatment to a patient, but also makes almost all cascades of carcinogenesis, including early cancer, invisible.

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Topographic association of Ki-67 and Bcl-2 expression with H. pylori infection, gastric atrophy, intestinal metaplasia: A role for antralization in gastric carcinogenesis?

Gastroenterology ◽

10.1016/s0016-5085(01)83262-5 ◽

2001 ◽

Vol 120 (5) ◽

pp. A656-A656

Author(s):

G ZHANG ◽

N TALLEY ◽

C HENWOOD ◽

J WYATT ◽

S ADAMS ◽

...

Keyword(s):

Intestinal Metaplasia ◽

Gastric Carcinogenesis ◽

Gastric Atrophy ◽

Ki 67 ◽

H Pylori

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Lgr5 Contributes to Intestinal Metaplasia During Gastric Carcinogenesis: A Meta analysis

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520615666150616123345 ◽

2016 ◽

Vol 16 (9) ◽

pp. 1079-1084

Author(s):

Ye Han ◽

Qiaoming Zhi ◽

Xiaofeng Xue ◽

Bin Yuan ◽

Hong Zhao ◽

...

Keyword(s):

Intestinal Metaplasia ◽

Meta Analysis ◽

Gastric Carcinogenesis

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Confocal laser endomicroscopy under propofol‐based sedation for early gastric cancer and pre‐cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

BMC Anesthesiology ◽

10.1186/s12871-021-01312-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Intestinal Metaplasia ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Patient Cooperation

Abstract Background Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions. Methods A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n = 126) and the un-sedated group (n = 100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines. Results The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95 % CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95 % CI: 0.80 to 0.97), P = 0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P = 0.0008 and P = 0.0001, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0 % in the sedated group and 27.59 % (95 % CI: 10.30–44.91 %) in the un-sedated group (P = 0.006). Conclusions Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).

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Intestinal Metaplasia -The Effect of Acid on the Gastric Mucosa and Gastric Carcinogenesis-

Journal of Toxicologic Pathology ◽

10.1293/tox.23.115 ◽

2010 ◽

Vol 23 (3) ◽

pp. 115-123 ◽

Cited By ~ 3

Author(s):

Hiromitsu Watanabe

Keyword(s):

Gastric Mucosa ◽

Intestinal Metaplasia ◽

Gastric Carcinogenesis

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DINAMIC SCREENING OF PRECANCEROUS ESOPHAGUS USING MOLECULAR GENETIC ANALYSIS

Siberian Journal of Oncology ◽

10.21294/1814-4861-2020-19-6-38-45 ◽

2020 ◽

Vol 19 (6) ◽

pp. 38-45

Author(s):

V. V. Anishchenko ◽

S. E. Titov ◽

T. L. Poloz ◽

Yu. A. Veryaskina ◽

A. A. Arkhipova ◽

...

Keyword(s):

Intestinal Metaplasia ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Morphological Changes ◽

Molecular Genetic ◽

Intraepithelial Neoplasia ◽

Molecular Genetic Analysis ◽

Gastric Adenocarcinomas ◽

Potential Development ◽

Risk Of Malignancy

Introduction. Esophageal adenocarcinoma develops from areas of intestinal metaplasia in Barrett’s esophagus, similar to how intestinal metaplasia transforms into gastric adenocarcinomas in the stomach. Atypia with intraepithelial neoplasia is difficult to distinguish from reactive and regenerative changes, especially in erosive mucosa of the esophagus. Observation of patients with Barrett’s esophagus allows the identification of adenocarcinoma in the earlier, more curable stages in many patients.The aim of our study was to study the prospects of using a classifier based on miRNA profiling in histological samples of Barrett’s esophagus to determine the risk of malignancy and treatment tactics.Material and Methods. In this study, 119 samples of archival histological material in the form of paraffin blocks were used: 89 samples of gastric mucosa with dysplasia and 30 samples of Barrett’s esophagus. The expression level of miRNA-145-5p, -150-5p, -20a-5p, -21-5p,-31-5p,-34a-5p,-375 was determined using real-time RT-PC R. Samples were stratified into different groups using the C-RT decision tree algorithm.Results. 26.7 % of Barrett’s esophagus samples were classified by expression of the proposed miRNAs as cancer, which may indicate a potential development of a malignant tumor in the mucosa of the esophagus when morphological changes have not yet been found.

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