Evaluation of Gastric Cancer Risk Using Topography of Histological Gastritis: A Large-scaled Cross-sectional Study

Abstract

We evaluated the topography of histological gastritis, which may be risk factors for gastric cancer (GCa). A total of 530 Helicobacter pylori-positive patients underwent diagnostic upper-gastrointestinal endoscopy. Biopsy specimens were obtained from the gastric antrum and body to assess the grade of gastritis. Subjects were divided into four groups by the topography of active gastritis (antrum predominant gastritis, AP; pan-gastritis with or without corpus atrophy, Pan-1 and Pan-2; and corpus predominant gastritis, CP). A higher prevalence of GCa followed the order of Pan 2-->CP-->Pan 1-->AP. The age of patients decreased in the same order. When we set Pan 2 and CP as a high-risk group, the sensitivity and specificity for GCa detection were 77.3 and 54.7%, which were superior to the serum criteria using pepsinogens. These suggest that topography of histologic gastritis is an important marker to identify the high-risk group.

H. pylori Infection Is a Key Risk Factor for Proximal Gastric Cancer

“…Overall, there was more severe active inflammation in the corpus than in the antrum which is in line with results of previous studies reporting of an increased risk for GC development in case of corpus-predominant gastritis [10,50]. We reported earlier that the H. pylori induced corpus gastritis is more severe especially in patients with gastric cancer [51].…”

Accuracy and Cut-Off Values of Pepsinogens I, II and Gastrin 17 for Diagnosis of Gastric Fundic Atrophy: Influence of Gastritis

“…Several studies have looked on the association between pepsinogens and topography of gastritis [27], [28], [29], [30]. Among these studies which used PGII or PGI/PGII ratio, either absence of association [31], or presence of association with pangastritis was reported comparing with corpus-spared gastritis [32], [33], [34]. None of these studies suggested a cutoff value for PGII to distinguish pangastritis, additionally exclusion of fundal atrophy was not always among criteria of pangastritis definition.…”

Pathogenetic role of the tyrosine-phosphorylated CagA EPIYA sequence of Helicobacter pylori in histological gastritis in Japanese patients

“…However, in Japan, most strains were cagA positive and most H. pylori were confirmed to have the East Asian type CagA [10,22,23]. Patients with duodenal ulcers are regarded as having a low risk of developing gastric cancer [24,25], however these patients…”