Type or extension of intestinal metaplasia and immature/atypical “indefinite-for-dysplasia” lesions as predictors of gastric neoplasia✯

Tava, Francesca; Luinetti, Ombretta; Ghigna, Maria Rosa; Alvisi, C; Perego, M.; Trespi, E.; Klersy, Catherine; Fratti, C.; Fiocca, Roberto; Solcia, Enrico

doi:10.1016/j.humpath.2006.05.012

Cited by 76 publications

(61 citation statements)

References 29 publications

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“…Francesca Tava et al's results on an endoscopic cohort of subjects with extensive IM are in keeping with those of Uemura et al [32] in showing prevention of progression to neoplasia through H. pylori eradication [33]. Altogether, available evidence suggests a role of H. pylori chronic gastritis both in the induction of lesions at increased risk of neoplasia and in their actual progression to neoplasia, thus supporting H. pylori eradication as a potentially effective preventive treatment.…”

Section: Discussionsupporting

confidence: 58%

Characteristics and Interactions of Helicobacter pylori and H. pylori-Infected Human Gastroduodenal Epithelium in Peptic Ulcer: A Transmission Electron Microscopy Study

Bai

Liu

et al. 2009

Dig Dis Sci

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Helicobacter pylori (H. pylori) has been presumed to be an initiating factor in a previously recognized chain of events, starting with active chronic gastritis and leading to atrophy of the mucosal membrane, intestinal metaplasia, dysplasia (intraepithelial neoplasia), and finally culminating in gastric carcinoma. Adherence of H. pylori to the gastroduodenal epithelium is believed to be an important step in the induction of active chronic inflammation of the mucosal layer. However, it is not clear how the pathogen chronically colonizes the gastroduodenal epithelium. In this study, 30 biopsy specimens from H. pylori-positive peptic ulcer (15 for gastric ulcer, 15 for duodenal ulcer) patients were examined by transmission electron microscopy (TEM) to observe the structural adherence of H. pylori to gastroduodenal epithelium while ten healthy postulants were served as controls. We also investigated the interaction between H. pylori and gastroduodenal epithelial cells. Morphological appearances of both the pathogen and the cells as well as features of colonization, attachment, and internalization were observed. H. pylori exhibited both spiral and coccoid forms. Cytoplasmic vacuolar degeneration played by the vacuolating toxin (VacA) was apparent in gastroduodenal epithelial cells. Specially, a number of tumor cells were found in H. pylori-positive gastric intestinal metaplasia (IM) mucosa under TEM which provided an ultrastructural evidence of IM carrying a particularly high risk for the development of gastric cancer.

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Section: Discussionsupporting

confidence: 58%

Characteristics and Interactions of Helicobacter pylori and H. pylori-Infected Human Gastroduodenal Epithelium in Peptic Ulcer: A Transmission Electron Microscopy Study

Bai

Liu

et al. 2009

Dig Dis Sci

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“…However, there were studies that showed that a relatively large number of patients had advanced GC, even though they had been followed at one-or two-year intervals. 8,9 Furthermore, MAPS was based on histologic confirmation which is hardly applicable in current screening endoscopic session. The OLGA system is a very useful tool for grading the severity of gastritis and assessing GC risk, though it requires biopsies to be taken.…”

Section: Discussionmentioning

confidence: 99%

Staging Gastritis Based on Endoscopic Atrophic Border Backed by Operative Link for Gastritis Assessment System in 158 Health Checkup Subjects: Single Center Study

Kim¹,

Lee²,

Choi³

et al. 2014

Korean J Helicobacter Up Gastrointest Res

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Background/Aims: Newer operative link for gastritis assessment (OLGA) system tried to stage gastritis in view of gastric cancer (GC) risk and endoscopic atrophic border (EAB) was well correlated with OLGA. We described the gastritis on the base of EAB during endoscopic sessions and classified them into high or low stage gastritis as suggested by Quach et al. and analyzed them. Materials and Methods: A total of 158 subjects who visit our health promotion center were graded on the base of EAB by conventional endoscopy and reallocated according to ages. Linear-by-linear association was performed to identify the differences of gastritis among age-groups. Results: In our study 31% of patients had atrophic gastritis (AG) over AG closed type 3∼open type 1 compatible with OLGA stages III/IV (high stage gastritis). High and low stage gastritis showed significantly different distribution at each age group. The proportion of endoscopically diagnosed high stage gastritis increased in proportion to age. Contrast to Quach et al. our study showed prevalence of high stage gastritis under 40s, even in 20s or 30s (P=0.002). Conclusions: OLGA based EAB is easy and useful in GC risk stratification. In our study unlike the previous study of Quach et al., high stage gastritis was found in younger age groups. We should and could make an effort to prevent GC in even younger age groups with the aid of EAB. Additionally we could get organized and communicable stratified data about GC risk.

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“…57 Basal gland atypia/pit dysplasia This type of dysplasia is synonymously known as gastric pit dysplasia-like atypia (DLA) or intestinal metaplasia with basal gland atypia (IN-BGA) ( Figure 6). 60 Although debated and considered as indefinite for dysplasia by many, there is evidence suggesting that these changes represent an independent predictor of neoplastic risk. Gastric pit DLA is defined as epithelial nuclear atypia akin to low-or high-grade dysplasia located at the base of the pits, but devoid of surface mucosal involvement.…”

Section: Phenotype Based Risk Of Carcinomamentioning

confidence: 99%

Gastric dysplasia: update and practical approach

Setia¹,

Lauwers²

2015

Diagnostic Histopathology

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Type or extension of intestinal metaplasia and immature/atypical “indefinite-for-dysplasia” lesions as predictors of gastric neoplasia✯

Cited by 76 publications

References 29 publications

Characteristics and Interactions of Helicobacter pylori and H. pylori-Infected Human Gastroduodenal Epithelium in Peptic Ulcer: A Transmission Electron Microscopy Study

Characteristics and Interactions of Helicobacter pylori and H. pylori-Infected Human Gastroduodenal Epithelium in Peptic Ulcer: A Transmission Electron Microscopy Study

Staging Gastritis Based on Endoscopic Atrophic Border Backed by Operative Link for Gastritis Assessment System in 158 Health Checkup Subjects: Single Center Study

Gastric dysplasia: update and practical approach

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