Characteristics and background mucosa status of early gastric cancer after Helicobacter pylori eradication: A narrative review

Wei, Ya-Li; Jiang, Chen; Han, Yi-Ping; Song, Wen; Li, Xiaoyu; Yin, Xiaoyan

doi:10.1097/md.0000000000031968

Cited by 3 publications

(2 citation statements)

References 73 publications

(129 reference statements)

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“…In addition, the general and endoscopic characteristics of patients who develop map-like redness remain unclear. [16][17][18] In clinical practice, it is important to correctly evaluate not only gastric atrophy and intestinal metaplasia, but also map-like redness in patients at high risk of gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, several clinical studies have demonstrated that map‐like redness is an endoscopic characteristic risk factor for gastric cancer in patients who received H. pylori eradication, but studies on the incidence rate after eradication and the timing of the development of map‐like redness are limited. In addition, the general and endoscopic characteristics of patients who develop map‐like redness remain unclear 16–18 . In clinical practice, it is important to correctly evaluate not only gastric atrophy and intestinal metaplasia, but also map‐like redness in patients at high risk of gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

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Risk of map‐like redness development after eradication therapy for Helicobacter pylori infection

Matsumoto,

Sugimoto,

Fukuzawa

et al. 2024

Helicobacter

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BackgroundMap‐like redness is a newly identified endoscopic risk factor for gastric cancer in patients who received Helicobacter pylori eradication therapy. However, the incidence rate of map‐like redness in patients who received eradication, and the risk factors for the development of map‐like redness remain unclear. We hence aimed to investigate the incidence rate of map‐like redness at 1‐year post H. pylori eradication, and evaluated its associations with map‐like redness and gastric cancer in relation with gastric condition.Materials and MethodsEndoscopic severity of gastritis and map‐like redness were retrospectively evaluated according to the Kyoto Classification of Gastritis in patients who had undergone endoscopy before and after H. pylori eradication therapy.ResultsThe incidence rate of map‐like redness for all 328 patients at a mean of 1.2 ± 0.6 years after eradication was 25.3% (95% confidence interval [CI]: 20.7%–30.4%). Patients who developed map‐like redness were older, had more severe atrophy and intestinal metaplasia, a higher total score of the Kyoto Classification of Gastritis both before and after eradication, and a higher rate of gastric cancer history than patients who did not have map‐like redness. On multivariate analysis, risk of map‐like redness was increased in patients with intestinal metaplasia (odds ratio [OR]: 2.794, 95% CI: 1.155–6.757) and taking acid inhibitors (OR: 1.948, 95% CI: 1.070–3.547). Characteristics of H. pylori‐positive patients with gastric cancer history were patients who were older (OR: 1.033, 95% CI: 1.001–1.066), taking acid inhibitors (OR: 4.456, 95% CI: 2.340–8.484), and with occurrence of map‐like redness after eradication therapy (OR: 2.432, 95% CI: 1.264–4.679).ConclusionsMap‐like redness is observed in one fourth of patients at 1‐year post eradication. Patients who developed map‐like redness were found to have severe intestinal metaplasia and taking acid inhibitors, and hence such patients require increased attention at surveillance endoscopy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of map‐like redness development after eradication therapy for Helicobacter pylori infection

Matsumoto,

Sugimoto,

Fukuzawa

et al. 2024

Helicobacter

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Endoscopic and morphometric analysis of the reduction of acute inflammatory process in the gastric mucosa after therapy with Regasthym Gastro

Барышникова¹,

Uspenskiy²,

Fominykh³

et al. 2023

Terapevticheskii arkhiv

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Aim. To analyze the anti-inflammatory efficacy of Regasthym Gastro (alpha-glutamyl-tryptophan) in the treatment of patients with chronic atrophic gastritis according to endoscopic and morphometric studies. Materials and methods. As part of a double-blind placebo-controlled study, the results of gastroscopy and histological (morphometric) studies were retrospective analyzed in 80 patients diagnosed with chronic atrophic gastritis associated with Helicobacter pylori in exacerbation: 43 patients took Regasthym Gastro, 37 patients placebo. The conclusions of the gastroscopy were structured in the form of a standardized scale, which included an assessment of criteria in points (from 0 to 3): thickness of folds, hyperemia, edema of the gastric mucosa, the signs of atrophy, metaplasia; the severity of the erosive process. The sum of points according to all criteria was used to assess the dynamics of the inflammatory process: positive dynamics; lack of dynamics; the pathological process is progressing. The results of the endoscopic examination were compared with morphometry data (the number of inflammation pool cells per 1 mm2 of gastric mucosa). Statistical processing of the results was carried out using the Statistica 12 application software package. Results. According to the gastroscopy, before therapy, hyperemia of the gastric mucosa was present in 82.5%, edema in 53.8%, erosion in 17.5%, signs of metaplasia in 12.5% of patients. After therapy with the investigated drug a statistically significant decrease in the severity of edema of the gastric mucosa (p=0.008), the total set of signs of acute inflammatory process (p=0.006), a decrease in the proportion of outcomes with negative dynamics of the inflammatory process (p=0.038) was revealed. Statistically significant (p0.05) correlations were found between gastroscopy data of inflammation and the number of neutrophil, eosinophil granulocytes, macrophages and lymphocytes per 1 mm2. Conclusion. Regasthym Gastro contributes to a significant decrease in the severity of the inflammatory process according to the evaluation of the results of gastroscopy and morphometry. It is possible to recommend the inclusion of this drug in the complex therapy of chronic gastritis to increase the effectiveness and reduce the risks of progression of inflammation.

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Autoimmune gastritis studies and gastric cancer: True renaissance or bibliometric illusion

Isakov

2024

World J Gastroenterol

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A bibliometric analysis of studies dedicated to autoimmune gastritis (AIG) recently published demonstrated a noteworthy surge in publications over the last three years. This can be explained by numerous publications from different regions of the world reporting the results of several studies that stimulated reassessment of our view of AIG as a precancerous condition. Follow-up studies and retrospective analyses showed that the risk of gastric cancer (GC) in AIG patients is much lower than expected if the patients ever being infected with Helicobacter pylori (H. pylori ) were excluded. The low prevalence of precancerous lesions, such as the incomplete type of intestinal metaplasia, may explain the low risk of GC in AIG patients because the spasmolytic polypeptide-expressing metaplasia commonly observed in AIG does not involve clonal reprogramming of the gastric gland and can be considered as an adaptive change rather than a true precancerous lesion. However, changes in gastric secretion due to the progression of gastric atrophy during the course of AIG cause changes in the gastric mic-robiome, stimulating the growth of bacterial species such as streptococci, which may promote the development of precancerous lesions and GC. Thus, Streptococcus anginosus exhibited a robust proinflammatory response and induced the gastritis-atrophy-metaplasia-dysplasia sequence in mice, reproducing the well-established process for carcinogenesis associated with H. pylori . Prospective studies in H. pylori -naïve patients evaluating gastric microbiome changes during the long-term course of AIG might provide an explanation for the enigmatic increase in GC incidence in the last decades in younger cohorts, which has been reported in economically developed countries.

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Characteristics and background mucosa status of early gastric cancer after Helicobacter pylori eradication: A narrative review

Cited by 3 publications

References 73 publications

Risk of map‐like redness development after eradication therapy for Helicobacter pylori infection

Risk of map‐like redness development after eradication therapy for Helicobacter pylori infection

Endoscopic and morphometric analysis of the reduction of acute inflammatory process in the gastric mucosa after therapy with Regasthym Gastro

Autoimmune gastritis studies and gastric cancer: True renaissance or bibliometric illusion

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