scholarly journals Chronic atrophic gastritis: an update on diagnosis

Author(s):  
Adriana Botezatu ◽  
Nicolae Bodrug

Background and aim. Atrophic gastritis is a precancerous gastric lesion, therefore its early detection is a priority in preventing gastric cancer. The aim of the present paper is to develop a narrative synthesis of the present knowledge on diagnostic methods of chronic atrophic gastritis. Methods. A literature search was carried out on main databases: PubMed, Hinari, SpringerLink and Scopus (Elsevier) for the period 2000-2020. The searched keywords were: chronic atrophic gastritis, intestinal metaplasia and dysplasia + diagnosis. Inclusion criteria were focused on the articles about the invasive and non-invasive diagnosis of chronic atrophic gastritis and of precancerous gastric lesions, intestinal metaplasia and dysplasia; exclusion criteria were articles published before 2000 and those that did not include the proposed theme. Results. The search returned 575 papers addressing the topic of precancerous lesions. From these, 60 articles were qualified representative for the materials published on the topic of this synthesis article, being those that met the inclusion criteria. The data emphasize the need to use upper digestive endoscopy with biopsies for the diagnosis of chronic atrophic gastritis. However serological diagnosis is available as alternative mainly recommended in follow up. Conclusions. There are two main methodological approaches for the evaluation of chronic atrophic gastritis as a precancerous gastric lesions: invasive examination, which requires histological analysis of biopsy samples taken during upper digestive endoscopy, being the "gold standard" for diagnosis, and non-invasive serological examination using markers of gastric function.

1995 ◽  
Vol 4 (2) ◽  
pp. 181-186 ◽  
Author(s):  
F Farinati ◽  
R Cardin ◽  
G D Libera ◽  
M Rugge ◽  
L Herszènyi ◽  
...  

Helicobacter ◽  
2009 ◽  
Vol 14 (4) ◽  
pp. 306-308 ◽  
Author(s):  
Bárbara Peleteiro ◽  
Carla Carrilho ◽  
Prassad Modcoicar ◽  
Lina Cunha ◽  
Mamudo Ismail ◽  
...  

2021 ◽  
Vol 84 (1) ◽  
pp. 9-17
Author(s):  
H Ibrahim ◽  
A Shams El-Deen ◽  
ZA Kasemy ◽  
M Saad ◽  
AA Sakr

Background and study aims : Atrophic gastritis (AG) and intestinal metaplasia (IM) are established premalignant gastric lesions. Many studies documented a poor correlation between esophagogastroduodenoscopy (EGD) and histopathological (HP) findings of precancerous gastric lesions. The aim was to bridge the gap between endoscopy and HP in detection of chronic gastritis, AG and IM. Patients and methods : a prospective single-center study involved 150 patients with endoscopic criteria of gastric lesions with upper gastrointestinal symptoms referred for upper GI endoscopy met the endoscopic criteria and classified according to HP of biopsies from targeted gastric lesions into chronic gastritis (GI), AG(GII) or IM(GIII). We correlated the endoscopic criteria of the 3 groups with the HP results. Results : (73males & 75 females) with ages ranged17-75 years and mean± SD was 41.96 ± 15.95. GI, GII &GIII were [42 patients (28%),82 patients (54.7%) and 26 patients (17.3%)], respectively. Diffuse gastric mottling was more common in GI (74.3%, P<0.001), visible submucosal vessels, gastric atrophy predominated in GII (75.6, 82.3 & 73.1% (P 0.005,0.4 & <0.01)), respectively. Whitish raised lesions were more specific in GIII (85.7%) (P<0.001). The sensitivity and specificity of endoscopic suspicion of chronic gastritis were (86&88% in GI), (87&85% in GII) and (54% &100% in GIII) (p-0.001). The logistic regression model for risk factors was χ2= 25.74 and 49.32, p < 0.001. Conclusion : Conventional endoscopy has high sensitivity and specificity for suspicion of chronic gastritis and AG, but low sensitivity and very high specificity for IM. Targeted biopsies may be valuable with image enhanced techniques.


2018 ◽  
Vol 4 ◽  
Author(s):  
Zahra Behrooznia ◽  
Pouya Ghaderi ◽  
Narges Jafarzadeh ◽  
Azra Izanloo ◽  
Sepideh Mansoori Majoofardi ◽  
...  

Gastric cancer is the fourth most common cancer and the second leading cause of cancer death worldwide. Although the global incidence of gastric cancer has been decreased dramatically in recent decades, north and northwest of Iran have the highest incidence rate of gastric cancer. Whilst the surgical procedures for gastric cancer have been improved, there is no cure for that. The intestinal type of GC results from pre-neoplastic conditions including atrophic gastritis, intestinal metaplasia and dysplasia. Trefoil Factors Family proteins (TFFs) are small and stable molecules secreted by the mammalian gastrointestinal tract. TFFs constitute a family of three peptides (TFF1, TFF2and TFF3) that are widely expressed in a tissue specific manner in the gastrointestinal tract. Variable TFFs expression in gastric cancer and pre-neoplastic lesions has been found. TFF1 has a tumor suppressor activity and inhibits tumorogenesis in gastric cancer. Its expression decreases in gastritis, gastric atrophy, dysplasia, intestinal metaplasia and gastric cancer.TFF2 has a protective effect on gastrointestinal epithelium. As a prognostic factor, TFF2 expression decreases in gastric ulcer, chronic atrophic gastritis and gastric cancer. TFF3 is considered as an oncogenic factor in gastric tissues. Whilst the normal gastric tissues don’t express TFF3, it increases in intestinal metaplasia. Therefore, more studies are necessary to clarify the role of TFFs in GC and pre-neoplastic conditions. This review has focused on elucidating the important role of TFFs in gastric cancer and pre-neoplastic lesions.


2021 ◽  
Author(s):  
Julia M. Lerch ◽  
Rish K. Pai ◽  
Ian Brown ◽  
Anthony J. Gill ◽  
Dhanpat Jain ◽  
...  

AbstractThe extent of gastric intestinal metaplasia (GIM) can be used to determine the risk of gastric cancer. Eleven international gastrointestinal expert pathologists estimated the extent of GIM on haematoxylin and eosin (H&E)- and Alcian blue-Periodic acid Schiff (AB-PAS)-stained slides of 46 antrum biopsies in 5% increments. Interobserver agreement was tested with the intraclass correlation coefficient (ICC). Correlation between standard deviation and extent of GIM was evaluated with the Spearman correlation. The interobserver agreement was very good (ICC = 0.983, 95% confidence interval (CI) 0.975–0.990). The use of AB-PAS did not increase the agreement (ICC = 0.975, 95% CI 0.961–0.985). Cases with a higher amount of metaplastic epithelium demonstrated a higher standard deviation (rs = 0.644; p < 0.01), suggesting lower diagnostic accuracy in cases with extensive GIM. In conclusion, estimating the extent of GIM on H&E-stained slides in patients with chronic atrophic gastritis can be achieved satisfactorily with high interobserver agreement, at least among international expert gastrointestinal pathologists.


2012 ◽  
Vol 49 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Judite Dietz ◽  
Jane Maria Ulbrich-Kulcynski ◽  
Katia Elisabete Pires Souto ◽  
Nelson Guardiola Meinhardt

CONTEXT: The prevalence of obesity has been increasing in modern society. Roux-en-y gastric bypass is a bariatric surgery that involves the exclusion of significant part of the stomach. Atrophy, intestinal metaplasia and gastric cancer have been associated with infection by Helicobacter pylori. OBJECTIVES: To evaluate the presence of endoscopy findings and histological changes in morbid obese patients for the presence of inflammatory cells, inflammatory activity, lymphoid hyperplasia, H. pylori infection, atrophy and intestinal metaplasia in the gastric mucosa. METHODS: Upper digestive endoscopy and gastric histopathological were studied in 126 obese patients in the preoperative evaluation for bariatric surgery. RESULTS: Upper digestive endoscopy abnormalities were diagnosed in 73/126 (57.9%) patients. In three patients (2.4%) the upper gastrointestinal endoscopy diagnosed gastric ulcer and one patient (0.8%) had duodenal ulcer. The histopathological from gastric biopsies of these obese patients showed 65.1% of mucosa inflammation, inflammatory activity in 50.0%, infection by H. pylori in 53.2%, lymphoid hyperplasia in 50.0% and atrophy and/or intestinal metaplasia in 16.7%. CONCLUSIONS: In present study, with routine preoperative upper gastrointestinal endoscopy and histopathological examination, were detected 57.9% patients with endoscopy abnormalities, high prevalence of infection by H. pylori (53%) and 16.7% of gastric atrophy and/or intestinal metaplasia.


2021 ◽  
Author(s):  
Sizhen Gu ◽  
Yan Xue ◽  
Shigui Xue ◽  
Yini Tang ◽  
Zhehao Hu ◽  
...  

Abstract Background: This study aimed to explore the main components and targets of E-Lian granule through which it reversed chronic atrophic gastritis with intestinal metaplasia, based on the traditional Chinese Medicine Integrated Pharmacology Network Computing Research Platform V2.0 (TCMIP V2.0) combined with GEO gene chips. It also aimed to construct various networks to predict and analyze the mechanism of E-Lian granule in treating gastric precancerous lesions. Methods: The effective traditional Chinese medicine components and targets of E-Lian granule prescription were obtained using TCMIP V2.0. The disease targets were collected using the TCMIP V2.0 platform and the verified gene chips in the GEO database, and the “drug components–targets” network, “compound–targets protein interaction network,” and “core compound targets–pathways network” were constructed using Cytoscape 3.6.1. The reliability of the predicted components and targets was verified using Pymol 1.7.2.1 and Autodock Vina 1.1.2 reverse molecular docking. Results: A total of 262 unique active components and 680 potential active targets of E-Lian granule were obtained. Moreover, 2247 unique disease targets of chronic atrophic gastritis with intestinal metaplasia were obtained by searching the “Disease/Symptom Target Database” combined with the GEO chip (GSE78523) and GeneCard database. Further, 178 complex targets and 38 complex core targets were obtained using Venn and Filter, respectively, such as ALB, TNF, PTGS2, RHOA, ESR1, HRAS, JUN, FOS, CASP3 and so forth. The GO and KEGG nrichment analyses showed that E-Lian granule reversed gastric precancerous lesions not only through the direct intervention of the cancer pathway, gastric cancer pathway, and epithelial signal transduction in Helicobacter pylori infection but also through PI3K/AKT, VEGF, MAPK, cAMP, cGMP, Th1/Th2,and other pathways. It also had a significant correlation with cholinergic, 5-hydroxytryptamine, dopaminergic, and other gastrointestinal hormone-related signals. Finally, the core target verified in the GSE78523 chip was successfully used to dock with the active components of E-Lian granules. The reliability of the prediction was also verified. Conclusions: The components and molecular mechanism of E-Lian granule in reversing chronic atrophic gastritis with intestinal metaplasia were predicted by integrated pharmacology, GEO chip, and reverse molecular docking, providing an important theoretical basis for further study of the effective substances and mechanism of E-Lian granule in treating chronic atrophic gastritis.


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