gastric atrophy
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Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6242
Author(s):  
Darina Kohoutova ◽  
Matthew Banks ◽  
Jan Bures

The mortality rates of gastric carcinoma remain high, despite the progress in research and development in disease mechanisms and treatment. Therefore, recognition of gastric precancerous lesions and early neoplasia is crucial. Two subtypes of sporadic gastric cancer have been recognized: cardia subtype and non-cardia (distal) subtype, the latter being more frequent and largely associated with infection of Helicobacter pylori, a class I carcinogen. Helicobacter pylori initiates the widely accepted Correa cascade, describing a stepwise progression through precursor lesions from chronic inflammation to gastric atrophy, gastric intestinal metaplasia and neoplasia. Our knowledge on He-licobacter pylori is still limited, and multiple questions in the context of its contribution to the pathogenesis of gastric neoplasia are yet to be answered. Awareness and recognition of gastric atrophy and intestinal metaplasia on high-definition white-light endoscopy, image-enhanced endoscopy and magnification endoscopy, in combination with histology from the biopsies taken accurately according to the protocol, are crucial to guiding the management. Standard indications for endoscopic resections (endoscopic mucosal resection and endoscopic submucosal dissection) of gastric dysplasia and intestinal type of gastric carcinoma have been recommended by multiple societies. Endoscopic evaluation and surveillance should be offered to individuals with an inherited predisposition to gastric carcinoma.


2021 ◽  
Author(s):  
Hee Kyong Na ◽  
Kee Don Choi ◽  
Young Soo Park ◽  
Hwa Jung Kim ◽  
Ji Yong Ahn ◽  
...  

Abstract Background/Aims: We aimed to develop an endoscopic scoring system to evaluate atrophic and intestinal metaplasia using narrow-band imaging (NBI) and near focus mode (NFM) to compare endoscopic scores with the Operative link for gastritis assessment (OLGA) and the Operative link for gastric intestinal metaplasia assessment (OLGIM). Methods: A total of 51 patients who underwent diagnostic esophagogastroduodenoscopy were prospectively enrolled and endoscopic scoring using NBI and NFM was performed. Four areas (the lesser and greater curvatures of the antrum and the lesser and greater curvature side of the corpus) were observed and biopsies were taken. The degree of atrophy was scored from 0 to 2 according to the Kimura-Takemoto classification (0: C0-1, 1: C2-3, 2: O1-3). The degree of metaplasia was scored from 0 to 4 (0: no metaplasia, 1: presence of metaplasia at the antrum, 2: presence of metaplasia at the corpus, add score 1: presence of metaplasia for 1/2> observed field of the picture at the antrum, add score 2: 1/2 > observed field of the picture at the corpus). The endoscopic scores were compared to the OLGA and OLGIM staging. Results: The correlation coefficient for atrophy between the endoscopic and histologic scores was 0.70 (95% CI: 0.52–0.81 p <0.001) and for metaplasia, it was 0.75 (95% CI: 0.60–0.85; p <0.001). For atrophic gastritis, endoscopic score > 1 correlated with OLGA stage III and IV with a sensitivity, specificity, positive predictive value, negative predictive value, and agreement of 88%, 74%, 75%, 87%, and 80.4%, respectively, and for metaplasia, an endoscopic score > 1 correlated with high OLGIM stage III and IV with 100%, 59%, 69%, 100%, and 78.4%, respectively. Conclusions: Endoscopic scoring for gastric atrophy and metaplasia using NBI-NFM correlate well with histologic staging.


2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Ufuk Kutluana ◽  
◽  
Ecem Kutluana ◽  
Ayse Kilciler ◽  
◽  
...  

Background: Gastric İntestinal Metaplasia (GIM) and Gastric Atrophy (GA) are pre-neoplastic lesions that can lead to gastric cancer. Nowadays, there are no recognized good biomarkers of GIM and GA. The neutrophil-to-lymphocyte ratio (NLR) is an economical, effective, and repetitive indicator of inflammation. We aimed to comparatively evaluate Red Cell Distribution Width (RDW) and the NLR. Methods: 88 patients with GIM and 48 patients with GA and 64 patients with non-atrophic-non-metaplastic gastritis were included in the study. NLR and RDW levels were measured in patients and controls. Results: NLR levels were significantly higher in patients with GIM than in controls (p < 0.05). NLR level was correlated positively with presence of GIM (p < 0.05), H.pylori presence in GIM and GA (p < 0.05), and menopause (p < 0.05). A multiple logistic regression analysis showed the GIM was predictor for elevated NLR (p < 0.05). According to the ROC curve analysis, the best cut-off NLR value to differentiate between patients with GIM from GA and/or controls was >2.92 (p < 0.05). In this study, we mainly found a significant association between GIM and NLR. Conclusions: NLR is significantly higher in patients with GIM. NLR can be an independent determinant factor for GIM. Keywords: Intestinal metaplasia; gastric atrophy; biomarker.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jong Min Park ◽  
Young Min Han ◽  
Ki Baik Hahm

Chronic Helicobacter pylori infection causes gastric cancer via the progression of precancerous chronic atrophic gastritis (CAG). Therefore, repairing gastric atrophy could be a useful strategy in preventing H. pylori–associated gastric carcinogenesis. Although eradication of the bacterial pathogen offers one solution to this association, this study was designed to evaluate an alternative approach using mesenchymal stem cells to treat CAG and prevent carcinogenesis. Here, we used human placenta-derived mesenchymal stem cells (PD-MSCs) and their conditioned medium (CM) to treat H. pylori–associated CAG in a mice/cell model to explore their therapeutic effects and elucidate their molecular mechanisms. We compared the changes in the fecal microbiomes in response to PD-MSC treatments, and chronic H. pylori–infected mice were given ten treatments with PD-MSCs before being sacrificed for end point assays at around 36 weeks of age. These animals presented with significant reductions in the mean body weights of the control group, which were eradicated following PD-MSC treatment (p &lt; 0.01). Significant changes in various pathological parameters including inflammation, gastric atrophy, erosions/ulcers, and dysplastic changes were noted in the control group (p &lt; 0.01), but these were all significantly reduced in the PD-MSC/CM-treated groups. Lgr5+, Ki-67, H+/K+-ATPase, and Musashi-1 expressions were all significantly increased in the treated animals, while inflammatory mediators, MMP, and apoptotic executors were significantly decreased in the PD-MSC group compared to the control group (p &lt; 0.001). Our model showed that H. pylori–initiated, high-salt diet–promoted gastric atrophic gastritis resulted in significant changes in the fecal microbiome at the phylum/genus level and that PD-MSC/CM interventions facilitated a return to more normal microbial communities. In conclusion, administration of PD-MSCs or their conditioned medium may present a novel rejuvenating agent in preventing the progression of H. pylori–associated premalignant lesions.


2021 ◽  
Vol 8 ◽  
Author(s):  
Song Wang ◽  
Fei Ye ◽  
Yuan Sheng ◽  
Wenyong Yu ◽  
Yingling Liu ◽  
...  

Purpose: It is very essential to diagnose gastric atrophy in the area with high prevalence of gastric cancer. Operative link for gastritis assessment (OLGA) was developed to detect the severity of gastric atrophy. The aim of this study was to develop and validate nomograms for predicting OLGA any-stage and stages III–IV in the Chinese high-risk gastric cancer population.Methods: We retrospectively analyzed 7,945 participants obtained by a multicenter cross-sectional study. We randomly selected 55% individuals (4,370 participants, training cohort) to analyze and generate the prediction models and validated the models on the remaining individuals (3,575 participants, validation cohort). A multivariate logistic regression model was used to select variables in the training cohort. The corresponding nomograms were developed to predict OLGA any-stage and stages III–IV, respectively. The area under the receiver operating characteristic curves and the GiViTI calibration belts were used to estimate the discrimination and calibration of the prediction models.Results: There were 1,226 (28.05%) participants in the training sample and 970 (27.13%) in the validation sample who were diagnosed with gastric atrophy. The nomogram predicting OLGA any-stage had an area under the curve (AUC) of 0.610 for the training sample and 0.615 for the validation sample, with favorable calibrations in the overall population. Similarly, the nomogram predicting OLGA stages III–IV had an AUC of 0.702 and 0.714 for the training and validation samples, respectively, with favorable calibrations in the overall population.Conclusions: The prediction model can early identify the occurrence of gastric atrophy and the severity stage of gastric atrophy to some extent.


2021 ◽  
Vol 15 (6) ◽  
pp. 1620-1622
Author(s):  
Muhammad Nazir ◽  
Talal Safdar ◽  
Mushtaq Ahmad ◽  
Muhammad Ikram ◽  
Nisar Khan Sajid ◽  
...  

Objective: The aim of this study is to determine the prevalence of cagA and babA of helicobacter pylori isolated from gastric atrophic patients. Study Design: Descriptive/Analytical Place and Duration: The study was conducted at Medicine/Gastroenterology department of Khyber Teaching Hospital and Peshawar Institute of Medical Sciences, Peshawar for six months duration from March 2020 to August 2020. Methods: Total one hundred and twenty patients of both genders were presented in this study. Patients were aged between 20-80 years of age. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. All patients of gastroduodenal disorders were undergone for isolation of bacteria by using standard techniques. Complete data was analyzed by SPSS 22.0 version. Results: Total 50 (41.7%) patients were males and 70 (58.3%) patients were females. Mean age of the patients were 41.96 ± 16 years with mean BMI 25.24 ± 4.8 kg/m2. Frequency of H pylori was isolated in 30 (25%) patients in which 13 patients had atrophic gastritis, 9 patients had gastric ulcer and 8 patients had acute gastritis. Prevalence of cagA gene was 16 (53.33%) and babA was 10 (33.33%) in H. pylori isolated patients. Significantly difference with p value <0.05 was observed between cagA positive strains and patients of gastric atrophic. The involvement of gastric atrophic patients was not correlated to the babA gene. Conclusion: We concluded in this study that different cagA positive H. pylori can be retrieved from gastric atrophy patients. Keywords: Gastric atrophy, Gastric cancer, cagA, babA, Helicobacter pylori


Author(s):  
Joon Seop Lee ◽  
Seong Woo Jeon ◽  
Hyun Seok Lee ◽  
Yong Hwan Kwon ◽  
Su Youn Nam ◽  
...  

2021 ◽  
Vol 5 (1) ◽  

Objectives: The aim of this study was to investigate the prevalence of intestinal metaplasia and its relation to H. Pylori infection, gastric atrophy, ulcer, age and gender in patients underwent esophagogastroduodenoscopy and gastric biopsy for upper gastrointestinal symptoms. Method: 200 gastric biopsy blocks examined for patients underwent esophagogastroduodenoscopy (EGD) and gastric biopsy, between January 2019 October 2020 at Gastroenterology and hepatology Hospital / Medical city / Baghdad / Iraq. Result: (67.5%) of patients examined in the study had H. pylori infection, while (20.5%) of the total number patients in the study had gastric intestinal metaplasia. There was significant association between Intestinal metaplasia with both active chronic inflammation and intestinal atrophy but there was no significant association between Intestinal metaplasia with both ulcer and H. pylori infection. Conclusion: gastric intestinal metaplasia encountered more in old age male patients with gastric atrophy and it is not solely related to h pylori, other risk factors could be responsible for it.


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