Possibility of non-invasive diagnosis of gastric mucosal precancerous changes

Abstract

AIM:To assess the possibility of non-invasive screening of atrophic chronic gastritis for preventing further development of gastric cancer. METHODS:One hundred and seventy-eight consecutive Helicobacter pylori (H pylori)-positive dyspeptic patients after detection of serum levels of pepsinogen-1 (PG-1) and gastrin-17 (G-17) by enzyme immunoassay were proposed for endoscopy and histology. The serologic and morphologic results were compared with estimating the sensitivity, specificity and prognostic values of the tests. RESULTS:There was statistically significant reverse dependence between the grade of stomach mucosal antral or corpus atrophy and the proper decreasing of serum G17 or PG1 levels. The serologic method was quite sensitive in the diagnosis of non-atrophic and severe antral and corpus gastritis. Also, it was characterized by the high positive and negative prognostic values. CONCLUSION:Detection of serum G-17 and PG1 levels can be offered as the screening tool for atrophic gastritis. The positive serologic results require further chromoendoscopy with mucosal biopsy, for revealing probable progressing of atrophic process with development of intestinal metaplasia, dysplasia or gastric cancer.Pasechnikov VD, Chukov SZ, Kotelevets SM, Mostovov AN, Mernova VP, Polyakova MB. Possibility of non-invasive diagnosis of gastric mucosal precancerous changes.

Assessing GastroPanel serum markers as a non-invasive method for the diagnosis of atrophic gastritis and <i>Helicobacter pylori</i> infection

“…These results are similar with what has been reported in many other countries for example Sipponen et al (2002) [18] in Finland; Väänänen et al (2003) [19] in Finland; Pasechnikov et al (2004) [20] in Russia; Cavallaro et al (2004) [21] in Italy respectively reported the accuracy, sensitivity and specificity of the GastroPanel test as (91%:89%:93:%); (81%:79%:91%); (84%:79%:96%) and (96%:78%:98%). There was however, a significant difference in the diagnosis of atrophic antrum gastritis between the GastroPanel and histology (p < 0.01).…”

Alteration of sister chromatid exchange frequencies in gastric cancer and chronic atrophic gastritis patients with and without H pylori infection

“…Cancer results from accumulated genetic or epigenetic alteration(s) in a variety of genes that directly or indirectly control cell division, cell differentiation, and cell death [37] . The development of gastric cancer in humans has been shown to be a multi-step process, ranging from chronic gastritis to atrophy, intestinal metaplasia, dysplasia and finally invasive cancer [2][3][4][5] . Exposure of cells to a variety of genotoxic and cytotoxic agents has the potential to elicit prolonged and dynamic changes that compromise the stability of the cellular genome [38] .…”

“…Establishment of inherited susceptibility factors is important to recognize individuals at a higher risk of developing gastric cancer, so that they may benefit from early detection and prevention programs. Recent studies have demonstrated a significantly increased risk for the development of gastric carcinoma in patients with CAG [3,4,64,65] . Patients with CAG have a markedly increased risk of GC, but the mechanism underlying this increased risk is not well understood.…”

“…The development of gastric cancer in humans has been shown to be a multi-step process, ranging from chronic gastritis to atrophy, intestinal metaplasia, dysplasia and finally, invasive cancer [2][3][4][5] . Multiple genetic and epigenetic alterations in oncogenes, tumor suppressor genes, cell-cycle regulators, cell adhesion molecules, DNA repair genes and genetic instability, as well as telomerase activation, are implicated in the multi-step process of gastric carcinogenesis.…”

Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal, healthy stomach

“…Recently, a European biomarker examination, GastroPanel (Biohit Plc, Helsinki, Finland), which not only assays Pg levels but also measures serum or plasma levels of gastrin-17 (G-17) and H pylori antibodies (HpAb) of both IgG and IgA class from the same sample using the ELISA technique has been validated [28][29][30] . In addition to corpus atrophy, the GastroPanel examination also allows exploration of the structure and function of the antrum mucosa, and can indicate the presence of intragastric acidity [31][32][33][34] .…”