Oxyntic gastric atrophy in<i>Helicobacter pylori</i>gastritis is distinct from autoimmune gastritis

Venerito, Marino; Varbanova, Mariya; Röhl, Friedrich-Wilhelm; Reinhold, Dirk; Frauenschläger, Katrin; Jechorek, Doerthe; Weigt, Jochen; Link, Alexander; Malfertheiner, Peter

doi:10.1136/jclinpath-2015-203405

Cited by 33 publications

(28 citation statements)

References 27 publications

(20 reference statements)

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“…Therefore, PG II could be a useful marker for corpus atrophy screening. However, according to Venerito et al, H. pylori-positivity might have a proper influence on the results, so the diagnostic performance of a serological test could be limited [31].…”

Section: Discussionmentioning

confidence: 99%

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

Sjomina

Pavlova

Daugule

et al. 2018

JGLD

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Aims: The aim of the study was to evaluate the rationale of blood pepsinogen (PG) testing in population based screening settings.Methods: Participants from a cross-sectional population-based study of cardiovascular risk factors in Latvia were invited to participate in the current study. Pepsinogen I and II were measured in blood samples taken during the initial study and at follow-up; upper gastrointestinal endoscopy was performed. There were three groups of patients: with moderately decreased (PG I< 70 ng/ml and PG I/PG II ratio < 3), with strongly decreased (PG I< 30 ng/ml and PG I/PG II ratio < 2), and with normal PG level. Biopsy with H. pylori detection was performed (updated Sydney system).Results: Results from 259 patients were analyzed. Pepsinogens were decreased in 133 (51.4%), H. pylori was positive in 177 (66.0%) cases. Mean age was significantly lower in patients with normal compared to strongly decreased PG level group (52.8 vs. 64.1 years, p<0.001). Prevalence of severe corpus atrophy was higher in the strongly decreased compared to the normal PG test group: 7.0% vs. 0%; the same tendency was noted in the distribution of OLGA stages III-IV – 10.5% and 0.0%, OLGIM stages III-IV – 3.5% and 0%, and low-grade dysplasia – 15.8% and 2.4% (p<0.05). Two cases of gastric cancer were found; both presented decreased PG levels. A strong association between H. pylori eradication and PG ratio dynamics was found (p<0.05).Conclusions: All high-risk lesions were found in the decreased PG test groups; two cancer cases were revealed.However, PG demonstrated low specificity and low value of repeated testing. The value of PG as a sole test for gastric cancer risk is limited.

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Section: Discussionmentioning

confidence: 99%

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

Sjomina

Pavlova

Daugule

et al. 2018

JGLD

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“…Autoimmune gastritis in conjunction with autoimmune thyroid disease has been reported previously. In a case–control study, the usefulness of serum PGI and PGI/II ratio for the identification of OGA in patients with autoimmune thyroid disease has been evaluated . Patients with autoimmune thyroid disease (cases, N=34) and goiter (controls, N=30) were prospectively enrolled in the study.…”

Section: Gastric Cancer: Screening For Preneoplastic Conditionsmentioning

confidence: 99%

“…In a case-control study, the | 41 usefulness of serum PGI and PGI/II ratio for the identification of OGA in patients with autoimmune thyroid disease has been evaluated. 8 Patients with autoimmune thyroid disease (cases, N=34) and goiter (controls, N=30) were prospectively enrolled in the study. PG I levels ≤25 μg/mL and PG I/II ratio ≤3 were indicative for OGA.…”

Section: Gastric Cancer: Screening For Preneoplastic Conditionsmentioning

confidence: 99%

Gastric cancer – clinical and epidemiological aspects

et al. 2016

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Gastric cancer (GC) ranks fifth for cancer incidence and second for cancer deaths. Epidemiological data showed that survivors of Hodgkin's lymphoma and patients with pernicious anemia etiologically linked to autoimmune gastritis are at increased risk of GC. Screening of patients with autoimmune thyroid disease by means of pepsinogen (PG) I and PG I/II detected autoimmune gastritis with oxyntic gastric atrophy in one of four patients and may be recommended for GC prevention purposes. The International Agency for Research on Cancer reported a positive association between consumption of processed meet and increased GC risk. A new GC risk prediction model based on biological markers, age, gender, smoking status, family history of GC, and consumption of highly salted food showed good predictive performance, and might prompt individuals to modify their lifestyle habits, attend regular check-up visits or participate in screening programs. A novel GC classification based on gene expression of primary resected cancers correlated with clinicopathological features. Noncoding RNA for GC screening remains the focus of multiple studies. Patients with early GC undergoing endoscopic resection are more likely to develop metachronous lesions than patients undergoing surgery and endoscopic surveillance is warranted in this special cohort. The addition of gastrectomy to chemotherapy did not improve survival of patients with advanced GC and a single noncurable factor. Apatinib, a novel oral vascular endothelial growth factor receptor 2 tyrosine kinase inhibitor, improved the median overall survival of patients with advanced GC and progressive disease after two or more lines of prior chemotherapy of nearly 3 months.

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“…The authors identified distinct clinical, morphological, and serological phenotypes for each group. H. pylori ‐negative autoimmune gastritis patients (N=18) were more likely to have a distinct autoimmune disease (OR 6.3, 95% CI 1.3‐29.8) with a severe corpus atrophy (OR 10.1, 95% CI 1.9‐54.1) and corpus intestinal metaplasia (OR 26.9, 95% CI 5.3‐136.5) . Another patient cohort was described by Villanacci et al .…”

Section: Autoimmune Gastritis and Pernicious Anemiamentioning

confidence: 95%

“…In a study performed by Venerito et al. in Germany, a group of patients with corpus mucosal atrophy caused by H. pylori infection was compared to H. pylori ‐negative autoimmune gastritis patients, assessing gastric biopsies, serum gastrin‐17, pepsinogen I and II levels, antibodies to H. pylori and CagA protein as well as antibodies to parietal cells and intrinsic factor. The authors identified distinct clinical, morphological, and serological phenotypes for each group.…”

Section: Autoimmune Gastritis and Pernicious Anemiamentioning

confidence: 99%

Helicobacter pylori infection and nonmalignant diseases

et al. 2017

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A substantial decrease in Helicobacter pylori-associated peptic ulcer disease has been observed during the last decades. Drug-related ulcers as well as idiopathic ulcers are becoming predominant and are more refractory to treatment; however, H. pylori infection still plays an important role in ulcer bleeding and recurrence after therapy. The effect of H. pylori eradication upon functional dyspepsia symptoms has been reviewed in this article and generally confirms the results of previous meta-analyses. Additional evidence suggests a lack of impact upon the quality of life, in spite of improvement in symptoms. The association of H. pylori with gastroesophageal reflux disease and Barrett's esophagus remains controversial with a majority of published studies showing a negative association. Furthermore, a strong inverse relationship between the presence of H. pylori and the esophageal eosinophilia was also reported. Several studies and a review addressed the role of H. pylori in autoimmune gastritis and pernicious anemia. The association of the above still remains controversial. Finally, the necessity of routine endoscopy and H. pylori eradication before bariatric surgery is discussed. Several studies suggest the rationale of preoperative upper endoscopy and H. pylori eradication prior to surgery. However, the prevalence of H. pylori infection prior to surgery in these studies generally reflects the overall prevalence of the infection in the particular geographic area. In addition, results on the role of H. pylori in developing postoperative complications remain controversial.

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Oxyntic gastric atrophy inHelicobacter pylorigastritis is distinct from autoimmune gastritis

Abstract: H. pylori-negative AIG has a distinct clinical, morphological and serological phenotype compared with advanced OGA in H. pylori gastritis.

Cited by 33 publications

References 27 publications

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

Gastric cancer – clinical and epidemiological aspects

Helicobacter pylori infection and nonmalignant diseases

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