Premalignant lesions and gastric cancer: Current understanding

Koulis, Athanasios; Buckle, Andrew; Boussioutas, Alex

doi:10.4251/wjgo.v11.i9.665

Cited by 50 publications

(40 citation statements)

References 101 publications

(87 reference statements)

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“…Generally, H. pylori infections cause gastric inflammation and a chronic inflammatory response that result in progressive mucosal damage. Eventually, the gastric mucosa transforms into metaplastic and dysplastic epithelia, which leads to gastric adenocarcinomas[ 3 ]. The development of GC is suggested to be related to the interactions between bacterial virulence factors, host genetic factors such as the human leukocyte antigen (HLA) gene, the immune response of the host, and environmental factors such as diet and smoking[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Association between human leukocyte antigen gene polymorphisms and multiple EPIYA-C repeats in gastrointestinal disorders

Sarıbaş

Demiryas

Yılmaz

et al. 2020

WJG

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BACKGROUND Polymorphisms of human leukocyte antigen (HLA) genes are suggested to increase the risk of gastric cancer (GC). AIM To investigate the HLA allele frequencies of patients with GC relative to a control group in terms of CagA+ multiple (≥ 2) EPIYA-C repeats. METHODS The patient group comprised 94 patients [44 GC and 50 duodenal ulcer (DU) patients], and the control group comprised 86 individuals [(50 non-ulcer dyspepsia patients and 36 people with asymptomatic Helicobacter pylori ( H. pylori )]. Polymerase chain reaction was performed for the amplification of the H. pylori cagA gene and typing of EPIYA motifs. HLA sequence-specific oligonucleotide (SSO) typing was performed using Lifecodes SSO typing kits (HLA-A, HLA-B HLA-C, HLA-DRB1, and HLA-DQA1-B1 kits). RESULTS The comparison of GC cases in terms of CagA+ multiple (≥ 2) EPIYA-C repeats showed that only the HLA-DQB1*06 allele [odds ratio (OR): 0.37, P = 0.036] was significantly lower, but significance was lost after correction (Pc = 0.1845). The HLA-DQA1*01 allele had a high ratio in GC cases with multiple EPIYA-C repeats, but this was not significant in the univariate analysis. We compared allele frequencies in the DU cases alone and in GC and DU cases together using the same criterion, and none of the HLA alleles were significantly associated with GC or DU. Also, none of the alleles were detected as independent risk factors after the multivariate analysis. On the other hand, in a multivariate logistic regression with no discriminative criterion, HLA-DQA1*01 (OR = 1.848), HLA-DQB1*06 (OR = 1.821) and HLA-A*02 (OR = 1.579) alleles were detected as independent risk factors for GC and DU. CONCLUSION None of the HLA alleles were detected as independent risk factors in terms of CagA+ multiple EPIYA-C repeats. However, HLA-DQA1*01, HLA-DQB1*0601, and HLA-A*2 were independent risk factors with no criterion in the multivariate analysis. We suggest that the association of these alleles with gastric malignancies is not specifically related to cagA and multiple EPIYA C repeats.

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Section: Introductionmentioning

confidence: 99%

Association between human leukocyte antigen gene polymorphisms and multiple EPIYA-C repeats in gastrointestinal disorders

Sarıbaş

Demiryas

Yılmaz

et al. 2020

WJG

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“…pseudo-pyloric metaplasia, or what is known as SPEM) [55,56]. SPEM is involved in hyperplastic/ dysplastic ECL cell proliferation, and may theoretically be associated with a higher risk of gastric adenocarcinoma [25, 57,58]. It is often more difficult to document the etiology of other forms of gastritis, but it may help to look for a systemic cause, as in Crohn's disease (Fig.…”

Section: Obtaining Gastric Mucosa Biopsy Samples: the Biological Ratimentioning

confidence: 99%

Gastritis: An Update in 2020

Sugano

Sacchi

Sbaraglia

et al. 2020

Curr Treat Options Gastro

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Purpose of review The gastritis constellation includes heterogeneous clinicopathological entities, among which long-standing, non-self-limiting gastritis, mainly due to Helicobacter pylori infection, has been epidemiologically, biologically, and clinically linked to gastric cancer development (i.e. “inflammation-associated cancer”). This review illustrates the updated criteria applied in the taxonomy of gastritis (Kyoto classification), elucidates the biological rationale for endoscopy biopsy sampling (heterogeneity of gastric mucosa), and finally reports the results of long-term follow-up studies supporting the reliability of biopsy-based gastritis staging as predictor of gastritis-associated cancer risk. Recent findings By assuming gastric atrophy as the “cancerization field” where (non-syndromic) gastric cancer mostly develops, recent long-term follow-up studies consistently demonstrate the prognostic impact of the gastritis OLGA staging system. Summary Helicobacter pylori eradication is the leading strategy in the primary prevention of gastric cancer. In a multidisciplinary dimension of secondary cancer prevention, the OLGA staging system reliably ranks the patient-specific cancer risk, thus providing the clinical rationale for a tailored follow-up strategy.

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Section: Introductionmentioning

confidence: 99%

“…Gastric cancer (GC) is the fifth most common cancer worldwide [1]. Its incidence is highest in China, Japan, South Korea, and East Europe, with a lower incidence in North America, Western Europe, and South-Central Asia [1]. In Japan, the five-year survival rate reaches up to 90% due to early detection from established screening protocols [2].…”

Section: Introductionmentioning

confidence: 99%

“…Although there is no guarantee or timeline for the development of GC, the progression to intestinal metaplasia is the point of no return [8]. The presence of background intestinal metaplasia allows for the evolution of low-grade dysplasia (due to early APC gene mutations) and highgrade dysplasia (due to TP53 mutations) which are associated with a higher risk of ultimate progression to GC [1].…”

Section: Introductionmentioning

confidence: 99%

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Hybrid Argon Plasma Coagulation for Treatment of Gastric Intestinal Metaplasia

Estifan¹,

Cavanagh²,

Grossman³

2020

Cureus

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Hybrid argon plasma coagulation (HybridAPC® [HAPC]) is an evolution of the standard argon plasma coagulation (APC) technology, where the application of APC is preceded by highpressure needleless submucosal injection. APC is indicated for the ablation of benign and dysplastic mucosal lesions, such as vascular malformations or Barrett's mucosa. HAPC offers safety and efficacy advantages over standard APC because the submucosal injection acts as a heat sink that disperses energy. This ensures that the underlying muscularis propria remains unaffected, and only the mucosal layer is coagulated in its entirety. An 81-year-old Hispanic male was found to have a 1.2-cm mucosal nodule along the incisura of the stomach. Pathology of the biopsy specimen revealed high-grade dysplasia, and he subsequently underwent endoscopic ultrasound examination, which confirmed the presence of an isolated gastric nodule with no deep invasion of the muscularis propria, consistent with a uT1N0Mx endosonographic staging. He then underwent endoscopic submucosal dissection of the lesion. Pathology of the excised specimen confirmed the presence of multifocal high-grade dysplasia, arising in the background of extensive intestinal metaplasia. The deep margin was clear; however, the lateral resection margins showed focal involvement of intestinal metaplasia with low-grade dysplasia. Surveillance endoscopy confirmed the persistence of diffuse intestinal metaplasia. He was then treated with widespread HAPC due to the presence of underlying diffuse intestinal metaplasia in the stomach. HAPC is an effective and efficient treatment modality for mucosal lesions. In one series of 50 patients, 96% achieved complete macroscopic remission of Barrett's mucosa after a median of 3.5 APC sessions, and 85% achieved complete histological remission. HAPC is a promising therapeutic modality as a thermal injury is targeted, and the depth of injury is contained. This provides immediate procedural efficacy and safety benefits, and reduces subsequent complications when compared with standard APC. We anticipate that the applications of HAPC will continue to grow, as this modality is adopted into common procedural parlance. This case appears to be the first to describe the use of HAPC for definitive treatment of diffuse intestinal metaplasia.

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Premalignant lesions and gastric cancer: Current understanding

Cited by 50 publications

References 101 publications

Association between human leukocyte antigen gene polymorphisms and multiple EPIYA-C repeats in gastrointestinal disorders

Association between human leukocyte antigen gene polymorphisms and multiple EPIYA-C repeats in gastrointestinal disorders

Gastritis: An Update in 2020

Hybrid Argon Plasma Coagulation for Treatment of Gastric Intestinal Metaplasia

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