Gastric Carcinoma in Autoimmune Gastritis: A Histopathologic and Molecular Study

Angerilli, Valentina; Vanoli, Alessandro; Celin, Giulia; Ceccon, Carlotta; Gasparello, Jessica; Sabbadin, Marianna; De Lisi, Giuseppe; Paudice, Michele; Lenti, Marco Vincenzo; Rovedatti, Laura; Di Sabatino, Antonio; Bazzocchi, Francesca; Lonardi, Sara; Savarino, Edoardo; Luchini, Claudio; Parente, Paola; Grillo, Federica; Mastracci, Luca; Fassan, Matteo

doi:10.1016/j.modpat.2024.100491

Cited by 2 publications

(1 citation statement)

References 43 publications

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“…In AAG, the state of marked hypergastrinemia may play a role in predisposing to the development of intestinal adenocarcinoma, which has been proposed to originate from stem cells whose proliferation is stimulated directly or indirectly, through ECL cells, by gastrin [123]. A recent multicentric study describing the histopathological and molecular features of GC lesions diagnosed in AAG patients showed a high neuroendocrine component (28%) in corpus GC, supporting this idea [126]. Further research is needed to shed light on the possible carcinogenetic mechanisms in AAG.…”

Section: Aag and Hypochlorhydria: Is There An Increased Risk Of Gastr...mentioning

confidence: 87%

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Vavallo,

Cingolani,

Cozza

et al. 2024

IJMS

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Autoimmune atrophic gastritis is an immune-mediated disease resulting in autoimmune destruction of the specialized acid-producing gastric parietal cells. As a consequence, in autoimmune atrophic gastritis, gastric acid secretion is irreversibly impaired, and the resulting hypochlorhydria leads to the main clinical manifestations and is linked, directly or indirectly, to the long-term neoplastic complications of this disease. In the last few years, autoimmune atrophic gastritis has gained growing interest leading to the acquisition of new knowledge on different aspects of this disorder. Although reliable serological biomarkers are available and gastrointestinal endoscopy techniques have substantially evolved, the diagnosis of autoimmune atrophic gastritis is still affected by a considerable delay and relies on histopathological assessment of gastric biopsies. One of the reasons for the diagnostic delay is that the clinical presentations of autoimmune atrophic gastritis giving rise to clinical suspicion are very different, ranging from hematological to neurological–psychiatric up to gastrointestinal and less commonly to gynecological–obstetric symptoms or signs. Therefore, patients with autoimmune atrophic gastritis often seek advice from physicians of other medical specialties than gastroenterologists, thus underlining the need for increased awareness of this disease in a broad medical and scientific community.

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Section: Aag and Hypochlorhydria: Is There An Increased Risk Of Gastr...mentioning

confidence: 87%

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Vavallo,

Cingolani,

Cozza

et al. 2024

IJMS

View full text Add to dashboard Cite

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Gastric Adenocarcinoma in Helicobacter pylori-Negative Autoimmune Gastritis: A Case Report and Literature Review

Kishikawa,

Takarabe,

Ichikawa

et al. 2024

Cureus

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Recent studies have suggested that gastric cancer does not occur in patients with Helicobacter pylori- negative autoimmune gastritis (AIG); however, this notion is controversial. We encountered a case of gastric cancer associated with AIG in which H. pylori infection was excluded. A woman in her 70s was referred to our hospital for endoscopic resection of an antral adenoma. An H. pylori antibodies test, stool antigens test, H. pylori culture, and histological analysis using Giemsa staining yielded negative results. AIG was suspected because the antrum was endoscopically normal but the body was severely atrophic, which are typical findings of AIG. Anti-parietal cell antibodies were 40-fold positive, the gastrin level was 2950 pg/ml, and the pepsinogen I level, pepsinogen II level, and pepsinogen I/II ratio were 6.3 ng/ml, 5.7 ng/ml, and 1.1, respectively. A pathological examination of the gastric body revealed severe oxyntic atrophy with hyperplasia of enterochromaffin-like cells, whereas the antrum showed no pyloric gland atrophy or inflammation. These findings indicated that the patient had H. pylori -negative AIG. Four years later, a depressed lesion in the lower body and a flat lesion at the angle were observed; the former was a poorly cohesive carcinoma, and the latter was a differentiated adenocarcinoma. Surgical resection revealed that the lesion in the lower body was a poorly cohesive carcinoma invading the submucosa with vascular involvement, whereas the lesion in the angle was an intramucosal differentiated adenocarcinoma. A review of previous studies of gastric cancer with H. pylori -negative AIG suggested that patients with histologically and serologically advanced gastritis are at high risk for carcinogenesis. Even in H. pylori -negative cases, severe gastric mucosal atrophy in AIG cases may indicate a carcinogenic risk; therefore, surveillance for gastric cancer is especially recommended for these cases. Large cohort studies on the association between H. pylori -negative AIG and gastric cancer are warranted.

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Gastric Carcinoma in Autoimmune Gastritis: A Histopathologic and Molecular Study

Cited by 2 publications

References 43 publications

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective

Gastric Adenocarcinoma in Helicobacter pylori-Negative Autoimmune Gastritis: A Case Report and Literature Review

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